bluuebunny/crossref_metadata_2025 huggingface dataset:
Three brothers in biology: bugs, birds, books, conservation, and politics
Authors: Cannings Robert A. , Cannings Sydney G. , Cannings Richard J.
Published: January 2025

Three Cannings brothers describe their intertwined but separate careers in Canadian biology: Rob as an entomologist, Syd as an entomologist and conservation biologist, and Dick as an ornithologist and politician. They emphasise the influence on their lives of the British Columbia’s Okanagan Valley where they grew up, the naturalist family in which they were raised, and the mentors who inspired them in their work. Bird study and nature interpretation in BC Parks were early enthusiasms and influences. Biological research, museum work, nature conservation, public education, and writing have dominated their careers. In Dick’s case, his public life has culminated in a decade of Canadian federal politics as a member of Parliament.

This article is modified from the closing plenary address presented at Entomology 2022, the joint annual meeting of the Entomological Society of America, the Entomological Society of Canada, and the Entomological Society of British Columbia, in Vancouver, British Columbia, Canada, 16 November 2022. The presentation also acted as the 2022 Heritage Lecture of the Entomological Society of Canada.
Perceived ease-of-usability and local tolerability using CGRP monoclonal antibody autoinjectors vs. syringes: an online questionnaire-based study in patients with migraine
Authors: Silvestro Marcello , Sozio Pasquale , Orologio Ilaria , Siciliano Mattia , Trojsi Francesca , Tessitore Alessandro , Tedeschi Gioacchino , Russo Antonio
Published: January 2025

Background: Monoclonal antibodies acting on the CGRP pathway (CGRP-mAbs) are characterized by subcutaneous administration via autoinjectors or prefilled syringes. Unfortunately, significant local tolerability concerns about injection site pain (ISP) may degrade patient comfort, increase the fear and stress of dose administration, and negatively impact patient adherence. The aim of the present cross-sectional study was to assess the experience of patients with migraine using either CGRP-mAbs prefilled syringes or autoinjectors regarding local tolerability and perceived ease-of-usability.
Methods: A self-administered electronic questionnaire was created using “Google questionnaires” to collect from migraine inpatients treated with CGR-mAbs: i) demographic and clinical parameters; ii) data related to ongoing preventive CGRP-mAb treatments and their local tolerability (in particular, evaluated by numerical rating scale); iii) data on perceived ease-of-usability; and iv) data on putative previous onabotulinumtoxinA treatment.
Results: The questionnaire was sent to 405 migraine patients. After 10 days, 283 (69.87%) patients had completed the electronic form. No significant differences were found among groups regarding data on ease-of-usability and local tolerability of CGRP-mAbs regarding simplicity and modality of administration (self-administered or not), ISP, or reactions at the site of administration. However, we did identify young females (OR=0.22; p<0.001) with chronic migraine (OR=4.87; p=0.007) to be the phenotype most prone to experience ISP during CGRP-mAbs treatment. Of 96 patients who had previously received at least 3 onabotulinumtoxinA administrations, injection site pain was significantly higher with onabotulinumtoxinA compared to CGRP-mAbs (6±4 vs. 4±5; p<0.001).
Conclusions: Devices used for CGRP-mAbs administration (auto-injector and prefilled syringes) are characterized by several strengths and disadvantages, one compensating for the other so that no differences in perceived ease-of-usability and local tolerability can be observed. These findings may also result in economic and ecological implications, considering the lower impact on costs and environmental pollution of prefilled syringes compared to more expensive and polluting plastic autoinjectors.
Cardiopulmonary resuscitation practices amid COVID-19 in four Gauteng public hospitals
Authors: Smit Almien , Engelbrecht Andreas , Rajan Suma
Published: January 2025

Background: The coronavirus disease 2019 (COVID-19) pandemic challenged healthcare systems worldwide. Owing to the transmission with aerosol-generating procedures, cardiopulmonary resuscitation (CPR) practices were changed. Little is known about the adherence and/or uptake of these guidelines by healthcare workers (HCWs) in lower-middle income countries. This study seeks to describe the CPR practices among HCWs in South Africa.Methods: This descriptive cross-sectional study used purposeful and snowball sampling to recruit 131 participants. Data were collected using a self-administered questionnaire and analysed using descriptive statistics.Results: A total of 131 responses were received. Of the respondents, 72.9% reported performing CPR on COVID-19-positive patients. Frequent breaches in personal protective equipment (PPE) (p  0.001) and reuse of PPE (p  0.001) were reported. Most respondents reported being aware of specific guidelines for CPR in COVID-19. Among the 53.4% of respondents who had tested positive for COVID-19, 79.7% reported occupational exposure. Of these respondents, 47.3% reported symptom onset within 5 days of performing CPR on a COVID-19-positive patient.Conclusion: HCWs often put the needs of patients above their own. The study found that despite respondents being aware of guidelines for CPR in COVID-19, compliance with guidelines was reported to be poor. Of particular concern is that a high number of respondents who tested positive for COVID-19 reported symptom onset within 5 days of performing CPR on COVID-19-positive patients.Contribution: This research will assist in the training of HCWs on appropriate CPR practices to prevent transmission of respiratory infections transmitted via droplet and airborne routes.
Cross-cultural adaptation: South African Gestational Diabetes Mellitus Knowledge Questionnaire
Authors: Manas Lorisha , Chivese Tawanda , Coetzee Ankia , Conradie Magda , Morris Linzette D.
Published: January 2025

Background: Many serious adverse events associated with gestational diabetes mellitus (GDM) can be mitigated by timely glucose control during pregnancy, achieved through education and lifestyle choices. The aim of this study was to translate and cross-culturally adapt and test the preliminary internal consistency and test-retest reliability of the South African English, Afrikaans and isiXhosa versions of the GDM Knowledge Questionnaire (GDMKQ).Methods: A prospective, observational study was conducted at a high-risk antenatal clinic in South Africa. Pregnant women ≥ 18 years with GDM were consecutively sampled. Semantic equivalence between the original and adapted versions was assessed. Face and content validity, internal consistency and test–retest reliability were evaluated.Results: The three SA-GDMKQ versions demonstrated good face and content validity. For internal consistency, Cronbach’s alpha values were 0.534 for the Afrikaans version, 0.434 for the English version and 0.621 for the isiXhosa version. Test–retest reliability found kappa (standard error [s.e.]) values ranged between −0.03 (0.18) and 0.89 (0.13) for the English version, between −0.07 (0.18) and 0.53 (0.13) for the Afrikaans version and between 0.28 (0.18) and 0.87 (0.17) for the isiXhosa version. All versions of the SA-GDMKQ had a statistically significant (p  0.001) positive linear correlation between the total scores.Conclusion: The English, Afrikaans and isiXhosa SA-GDMKQ versions were found to be feasible and easy to comprehend, although lower internal consistency and test–retest reliability were displayed. Further validation of the psychometric properties of the English, Afrikaans and isiXhosa versions of the SA-GDMKQ among larger sample groups is however warranted.Contribution: This study adds to the knowledge around developing and using culturally appropriate questionnaires and outcome measures in research and clinical practice.
Final-year students’ perceptions of online integrated primary care learning
Authors: Ruch Aviva , Francis Joel , George Ann Z.
Published: January 2025

Background: Integrated primary care (IPC) is a final-year medical subject at the University of the Witwatersrand, Johannesburg, South Africa. It focusses on primary health care training. The coronavirus disease 2019 (COVID-19) pandemic exacerbated existing decentralised training challenges, including standardisation and patient exposure. This study explored IPC students’ experiences and perceptions of online learning during the COVID-19 pandemic.Methods: This explanatory-sequential mixed-methods study was informed by the technology acceptance model, community of inquiry model and self-regulated learning theory. A cross-sectional online survey was followed by focus group discussions (FGDs) (n = 2 and n = 3, respectively). All 316 medical students in the 2021 cohort were eligible to participate. Closed-ended survey responses were analysed using descriptive and inferential statistics. Open-ended responses were analysed using content analysis. The FGDs were thematically analysed.Results: The survey response rate was 52% (n = 164/316). Most students found the online content easily accessible (93.3%) and logically organised (80.0%). The course structure and organisation, and the range of online activities offered were the main features that supported learning. The main challenges included the content not being comprehensive and the difficulty of learning patient management from online content. Suggested improvements related to the course design and ways students and instructors can maximise the affordances of the online course.Conclusion: Acknowledging the limitations of learning clinical content online, the participants felt the course supported their learning. Our findings suggest that well-designed online content can augment clinical learning.Contribution: This study contributes to the discourse on the value of online learning for clinical teaching.
Assessment of health and safety knowledge among teachers of public schools
Authors: ALShamsi Najla Salim , Ismail Ahmad Rasdan , Okoh Anthony I.
Published: January 2025

Background:

This study assessed the knowledge and safety practices of public-school teachers in the Emirate of Sharjah, United Arab Emirates (UAE). The education system in the UAE is relatively new and has been the subject of academic debate for the past decade. Safety awareness refers to perceptions and assessments of the abilities and responsibilities of employees to mitigate risks in the workplace. This study assessed safety related to educational institutions, the efficiency of the safety training process imparted by the stakeholders for the teachers, and the extent to which schools in Sharjah are applying and are committed to the safety standards, policies, and procedures.

Methods:

A cross-sectional study design was used that encompassed public schools in the Emirate of Sharjah, UAE. Data were collected from 271 respondents using an online questionnaire prepared in English, Arabic, or Chinese.

Results:

The results revealed that more than 90% of the respondents had strong knowledge and awareness of health and safety in their workplace, specifically within the school community. Social demographic factors were not associated with this awareness, except for the perceived importance of occupational health and safety. Sex is a significant factor in awareness of the importance of health and safety of employees and students (P < 0.019).

Conclusion:

We conclude that there is excellent awareness of occupational health and safety among teachers in the education sector in the Emirate of Sharjah, UAE. The results of this study emphasize the importance of safety policies, safety training, and safety committees to improving safety culture at educational institutions.
Symptomatic Cervical Carotid Artery Stenosis: Evolving Paradigms in Risk Stratification and Intervention
Authors: Sebastian Ivy Anne , Barakhanov Kazbek , Ganesh Aravind
Published: January 2025

Symptomatic carotid disease, characterized by atherosclerotic or non-atherosclerotic internal carotid artery disease with ipsilateral stroke symptoms, represents a critical condition in stroke neurology. This “hot carotid” state carries a high risk of stroke recurrence, with almost one-fourth of the patients experiencing recurrent ischemic events within 2 weeks of initial presentation. The global prevalence of significant carotid stenosis (conventionally defined as ≥50% narrowing) is estimated at around 1.8% in men and 1.2% in women and increases with age. Management of symptomatic carotid disease remains challenging, requiring a balance between urgent medical and surgical interventions and their associated risks. Current treatment approaches combine medical management, focusing on optimal antithrombotic therapy, with revascularization procedures such as carotid endarterectomy or carotid artery stenting. However, decision making has evolved beyond considering stenosis degree alone, now incorporating advanced imaging data on plaque composition and intraluminal characteristics. Even though there are numerous randomized trials, uncertainties persist regarding optimal management, particularly in light of improved medical therapies and emerging concepts like symptomatic non-stenotic carotid disease. Future research directions include exploring newer antithrombotic regimens, refining patient selection criteria for revascularization, and evaluating novel techniques like transcarotid artery revascularization.
Dual Autonomously Functioning Thyroid Nodule: An Unusual Imaging Finding
Authors: Singhal Tejasvini , Agrawal Kanhaiyalal , Tripathy Tara Prasad , Parida Girish Kumar
Published: January 2025

A 48-year-old female, a known case of ulcerative colitis, on routine workup, was incidentally detected to have biochemical hyperthyroidism. 99mTc pertechnetate thyroid scintigraphy performed for the evaluation of hyperthyroidism revealed two foci of increased tracer uptake in the right thyroid lobe with suppressed uptake in the rest of the thyroid gland consistent with dual autonomously functioning thyroid nodules.
Utility of Cross-sectional and Correlative Imaging in Differentiated Thyroid Carcinoma with Unusual Presentation of Adrenal Metastases – Case Series and Review of Literature
Authors: Aggarwal Piyush , Krishnaraju Venkata Subramanian , Sood Ashwani , Mathur Yamini , Bhattacharya Anish , Mittal Bhagwant Rai
Published: January 2025

Differentiated thyroid carcinoma (DTC) metastasizing to the adrenal glands is very infrequent. We present three cases of DTC with adrenal metastasis in their follow-up, in which two were from follicular thyroid carcinoma and one from papillary thyroid carcinoma along with review of literature to emphasize the role of cross-sectional and correlative imaging in DTC with adrenal metastasis.
The Use of titanium screw to block nerve regeneration in a patient with trigeminal neuralgia
Authors: Lian Chin Boon , Ngeow Wei Cheong
Published: January 2025

The use of titanium screw to block nerve regeneration in a patient with trigeminal neuralgia is described. Though not a conventional mean of treatment in the management of trigeminal neuralgia, the use of screw to block nerve regeneration should be considered in difficult to treat cases where all other sources are exhausted. Such technique can provide pain relief for up to 5 years.
Vertical osteodistraction – A method for preimplantological regeneration of the alveolar ridge
Authors: Haupt E. , Langowsky K. , Walter M. , Eckelt U.
Published: January 2025

A new and effective therapy for increasing the alveolar ridge is vertical osteodistraction where in-between the bone segments to be distracted, new bones develop. Twelve patients (average age of 54) consisting of 9 females and 3 males were operated on and treated by using submucous extraosseous micro and mini distractors.

Among 8 patients presenting with an atrophy of the alveolar ridge, 6 cases were distracted in the interforaminal region and 2 cases in the molar region. In another 2 cases, osteodistraction of a free iliac crest transplant was performed to reconstruct the defect after tumour resection and for the remaining 2 cases, osteodistraction was used to rectify the defect caused by fractures of the alveolar process.

The expected bone regeneration in the distraction gap occurred in 11 patients but in one patient with a history of diabetes mellitus, the poor bone healing led to the loss of the osteotomised bone segment.

After distraction and prior to implant insertion a vestibuloplasty was necessary in 3 patients. Implant systems used were the Frialit-II-System (9 cases) and the IMZ- System (3 cases).

We see the advantage of the osteodistraction in contrast to the conventional free bone transplantation. Simultaneously, aside from an increase in the local regenerated bone, there is also a gain in the soft tissue of the attached mucosa.
Late rehabilitation of a case of maxillofacial sports injuries with Frialit-2 implants for predictable good function and aesthetics
Authors: Ong Ah Hup Michael
Published: January 2025

There are many implant systems today but most case reports are based on studies of the Branemark implants. With the various rehabilitation options and implant systems available, removable and conventional fixed partial prostheses are becoming less desirable. Without additional surgery or grafting, patients will opt to restore lost anterior teeth with endosseous implants as they can ensure adequate function and aesthetic results. Late implant placement in maxillofacial trauma- related cases can enhance the health and quality of life of patients who still enjoy sports activities by providing predictable good masticatory function, speech and aesthetics. A case of oral rehabilitation of sports-related injuries using the Frialit- 2 implants for the replacement of lost anterior maxillary teeth is reported and its technical options as well as long-term review are highlighted.
Prevalence and management of zygomatic fractures in a Malaysian population
Authors: SU Kumar , WC Ngeow
Published: January 2025

A total of 282 cases of zygomatic fracture treated at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry between 1977 and 1996 were reviewed. Slightly more than 41% of the patients were Chinese, 30% Malay, 26% Indian and 3% other races. Patients' age ranged from 6 to 59 years. The mean age was 28 years old. The majority of patients were male, with a male to female ratio of 6:1. The highest incidence of fracture was in the 20-29 years age group (50% of all patients). Sixty percents of the patients sustained zygomatic fracture alone. The remaining had associated fractures of the maxilla (17%), mandible (12%), orbital rim and frontal bone (7%), nasal bone (3%) and other non-maxillofacial bone (2%). More than half of the patients (58%) were treated by simple elevation via the Gillies temporal approach alone that did not require additional fixation.
Complete second branchial cleft fistula
Authors: ZAA Rahman , SM Ismail , MA Jalaludin
Published: January 2025

This report describes the case of a complete second branchial fistula that presented as a persistent discharging sinus in the lower neck associated with pain and swelling in the neck and throat, in a 19-year-old girl. Diagnostic-imaging modalities to aid in diagnosis and treatment plan are discussed. The surgical technique of removing the fistula through a vertical incision anterior to the sternocleidomastoid muscle and an upward dissection is described along with a discussion on other surgical methods.
Unilateral telecanthus following Naso-Orbito-Ethmoidal fracture
Authors: S Iqbal , AR Samsudin
Published: January 2025

Naso-orbito-ethmoidal fractures are not uncommon fractures of the maxillofacial complex. 4.3%-7.1% of facial fractures are associated with traumatic telecanthus. The complex anatomy of the region and difficult access makes it a difficult task to manage this fracture. Early surgical management is recommended because delayed repair or inadequate treatment predisposes to defects that may be difficult to correct with secondary procedures. A case of late treatment of NOE fracture with traumatic telecanthus and blindness is presented.
Preoperative Cardiac Risk Assessment For Noncardiac Surgery
Authors: Halmey N , Imran Z A , Haizal H K
Published: January 2025

Preoperative cardiac assessment aims to estimate the risk of major adverse cardiovascular events in the perioperative period. Guidelines exist to aid surgeons, anaesthetists and physicians in the management of patients with cardiac problems on the strength of the evidence for risk assessment and diagnostic testing. Assessment is divided into assessment of patient-specific risk, functional capacity and surgery-specific risk. The basic clinical evaluation obtained by history, physical examination and review of the electrocardiogram (ECG) usually provides sufficient data to evaluate cardiac risk.

This evaluation will enable recommendations to be made regarding further non- invasive and invasive investigations. Beta-blockers, statins and coronary revascularisation may then be indicated to lower cardiac risk.
The intercanthal and interpupillary distances in KadazanDusun in Malaysia
Authors: Ngeow Wei Cheong , Akan Adelina , George Jaclyn @ Marlyn
Published: January 2025

The normal range of intercanthal distance (ICD) and interpupillary distance (IPD) have not been recorded from Malaysians. The aim of this study was to establish the ICD and IPD in the Kadazan Dusun ethnic stock of Malaysia. A total of 140 samples consisting of 70 adult males and 70 adult females were recruited from an outpatient oral surgery clinic. ICD was measured between the median angles of the palpebral fissures and IPD was measured between the midpoint of the pupils. Measurements were done twice to the nearest 0.5 mm by two different researchers using a caliper and metal ruler. A mean was taken out of these two measurements. It was found that ICD ranged from 27.0 mm to 38.0 mm, with a mean of 33.0 (SD ± 2.3 mm). Generally, ICD was higher in male (mean 33.3 ± 2.1 mm) than female (mean 32.6 ± 2.6 mm). IPD ranged from 53.0 mm to 73.0 mm with a mean of 63.2 mm (SD ± 3.3 mm). Generally, IPD was higher in male (mean 64.6 ± 3.2 mm) than female (mean 61.2 ± 3.0 mm). The measurement on male and female was only statistically significant for ICD (independent t-test; p < 0.05). Previous study on Caucasian and Black ICD indicates an average of 32 ± 3 mm and 33.9 ± 3.0 mm respectively and an average of 63 ± 3.0 mm for Caucasian's IPD and 63.7 ± 3.7 mm for black's IPD. This study suggests that the ICD and IPD in KadazanDusun are within the range of that of the whites, black and mixed populations.
A four year retrospective study of facial fractures in Hospital Taiping
Authors: J.K. Ferdinand
Published: January 2025

A retrospective study of patients with facial fractures presenting to the Oral Surgery Unit, Hospital Taiping, during a four-year period from 2002 to 2005 was carried out. 204 patients sustained 325 fractures. Male to female ratio was 6.1:1. Patients aged 13-29 comprised the largest group (62%). Motor vehicle accidents were the predominant aetiological factor (89.2%). The ratio of fractures of the mandible to midface was 0.98:1. The mandibular parasymphysis was the most common anatomical site of mandibular fractures, and the zygoma was the most common bone involved in mid-face trauma. Closed reduction (inter-maxillary fixation, suspension wires, elevation) was the most frequent method of treatment (41.6%).
Adenocarcinoma of the maxilla
Authors: Abidin Marzuki Zainal , Mustafa Wan Mahadzir
Published: January 2025

Oral malignancy in pregnancy is a rare combination, not usually suspected by the attending clinician. This may result in delay in the diagnosis and provision of treatment thereby compromising the outcome. We report a case of adenocarcinoma in the maxilla presenting at full term of pregnancy, in a 28 year old woman.
Ectomesenchymal chondromyxoid tumour of the anterior tongue
Authors: Mohamad K. , Lau S.H.
Published: January 2025

The ectomesenchymal chondromyxoid tumor (EMCT) of the anterior tongue is a rare and newly described entity. It presents clinically as a firm, painless, and slow growing mass that typically affects the anterior dorsum of the tongue. It has been reported to occur over a wide age range (9 to 78 years) and has no apparent sex predilection. Histologically, the tumor is composed of a well circumscribed, unencapsulated lobular proliferation of fusiform and polygonal cells in a chondromyxoid matrix. We report one such case that conform to the features described for the EMCT in a 32 years old Indian female.
The intercanthal and interpupillary distances of three major ethnics in Malaysia
Authors: Al Junid S. Tahirah , W.C Ngeow
Published: January 2025

The normal range of intercanthal distance (ICD) and interpupillary distance (IPD) have only been reported in one minor ethnics group in Malaysia, the KadazanDusun. The aim of this study was to establish the ICD and IPD in the three major ethnic stocks in Malaysia, namely the Malays, Chinese and Indian. A total of 300 samples consisting of 50 adult males and 50 adult females of each ethnic stock were recruited from the campus of the University of Malaya. ICD was measured between the median angles of the palpebral fissures and IPD was measured between the midpoint of the pupils. Measurements were done twice to the nearest 0.5 mm by one researcher using a caliper and a metal ruler. A mean was taken out of these two measurements. If there were major discrepancies, a third reading was taken and two closest measurements were accepted. In ICD measurement, the means of all three group were highly significantly different from each other. The widest space between inner canthus was recorded in both sexes of the Chinese followed by the Malay and the narrowest space was noted in both sexes of the Indians. Gender variation is statistically significant where the males tend to have a wider intercanthal distance compared to females in all three ethnic groups. There was no significant difference between the mean IPD values among the three ethnics. However highly, statistically significant difference (independent t-test <0.001) was seen when comparing between the two sexes; the male generally had a wider IPD to the female in all the races. The ICD and IPD in this study samples were within the range of those in the KadazanDusun, whites, black and mixed populations.
Perioperative oral antibiotics in third molar surgery
Authors: Royan Stephen J. , Othman Kamsinah , Mustapha Zuhaibah
Published: January 2025

The aim of this study was to evaluate the usefulness of antibiotics in preventing post-operative infection in third molar surgeries.

The study was retrospective with information obtained from patient records. The operations carried out by two surgeons in the course of two years were studied. In 2002, Surgeon A routinely prescribed Oral Metronidazole 400 mg tds post- operatively for five days (Group A02) whereas Surgeon B prescribed Oral Metronidazole 800 mg pre-operatively and 2 doses of 400 mg post-operatively (Group B02). In 2003, antibiotics were not routinely prescribed by either surgeon (Group A03 and B03). The proportion of post-operative infections seen in Groups A02 and A03 and that in Groups B02 and B03 were compared.

The number of infections in Group A02 was one out of 35 and in Group A03, two out of 43. Out of 36 patients in Group B02, there were no infections and in Group B03, it was three out of 43. However, using Fisher's exact test, there was no statistically significant difference between the infections seen in Groups A02 and A03 (p=1.000) and Groups B02 and B03 (p=0.109) respectively.

In conclusion, no significant benefit could be demonstrated by administering perioperative oral antibiotics to prevent post-operative infection in third molar surgery.
Craniofacial anthropometric norms of the Orang Kuala of Johor, Malaysia
Authors: Ngeow Wei Cheong , Chai Wen Lin , Jelon Md Arad , Parumo Rosliza bt.
Published: January 2025

This study was done to establish the craniofacial anthropometric norms of adult Orang Kuala, a sub-group of Orang Asli (indigenous people) of Malaysia. The study group consisted of convenient samples of villagers who volunteered for the study. The mean age was 28.95 (9.34) years. The participants were generally healthy and exhibited no craniofacial abnormalities and had no history of plastic or reconstructive surgery. Subjects of mixed parentage were excluded from this study. Standard anthropometry instruments and methods were employed. Twenty- one (21) linear measurements were taken from twenty-two landmarks over five craniofacial regions. The methodology was adapted from Hajnis et al. Orang Kuala's intercanthal width is consistent with that reported among other ethnics. Their nasal feature mimics that of the classic negroid nose i.e. wide alar and short nose. They were also noted to have a long head with decreased head height and narrow head width, indicating a dolichocephalic (long narrow) head. In the orbital region, they have increased biocular width as well as eye fissure length, but with small eye opening. This gives them long narrow-slit eye, similar to that normally noted in the Chinese. They also manifests some facial features of the Malay, namely almost similar length in face height and mandible width, but a decrease upper face and mandibular height, giving them a stout lower jaw profile. In conclusion, this study establishes the craniofacial anthropometric norms of the Orang Kuala over 21 parameters. The findings suggested that the Orang Asli Kuala manifested facial features that are a mixture between the African (negroid) and the Malay and Chinese, both of whom are of Mongoloid stock.
The pattern of maxillofacial fractures in Ministry of Health Hospitals Malaysia
Authors: Mustafa WM , KK Tay , IP Chelvanayagam , Mutalib KA , Najardin Y , Razali A Rahman , BC Ma , KM Yuen , SJ Royan , Celestine V , C Vincent , AR Rusdi
Published: January 2025

OBJECTIVE:

To determine the pattern of facial fractures at 23 Malaysian hospitals.

PATIENTS AND METHOD:

A one year prospective study was carried out. The data collected include age, gender, etiology, sites of fractures and treatment. RESULTS: 2101 fractures were found in 1862 patients. Most fractures occurred in the age range 20 to 29 years old (mean 29.2, 642 cases, 34.5%). Males outnumber females by a ratio of 6:1. Most fractures were caused by road traffic accidents (RTAs) (79.59%), assaults (7.62%) and falls (6.50%). The majority of RTAs cases involved motor cyclists. Most facial fractures occurred in Malays (1155, 62.1%), followed by Indians (268, 14.4%), Chinese (262, 14.1%) foreigners (109, 5.9%) and other indigenous groups 63 (3.4%). The ethnicity was unknown in three cases. The commonest bones involved were the mandible (1075, 51.2%), followed by zygoma (495, 23.6%), maxilla (415, 19.8%), isolated orbital (82, 3.9%), nasoethmoidal (19, or 0.9%) and frontal bone fractures (15, 0.7%). The commonest method of treatment used was conservative treatment (33.2%), followed by ORIF (31.5%), and Closed reduction (29.6%). 4.7% of the patients refused treatment. CONCLUSION: Maxillofacial fractures as a result of RTAs are still very high and are usually associated with the male motorcycle riders and pillion riders. Current preventive measures have little impact on motorcyclists in Malaysia.
Review of Ameloblastoma over 19 years Period – One single operator's experience
Authors: Jalil Norma Abd.
Published: January 2025

A retrospective study on patients with ameloblastoma treated by the same surgeon at the Hospital Queen Elizabeth, Kota Kinabalu, Sabah, over a 19 year period (1987 – 2005) is reported. The number of patients recorded was fifty. The paper seeks to document the findings according to the ages at presentation of tumour, gender, site of tumour, racial group, mode of treatment and recurrence behavior.
A Five-Year Retrospective Study of Dentofacial Injuries Among Preschool Children In Melaka, Malaysia
Authors: Royan Stephen Joseph , Ee Pei-Shan , Gunarajah Dharmindra Rajah
Published: January 2025

AIM:

To determine the pattern of dentofacial injuries seen among pre-school children in a public hospital dental service in Melaka, Malaysia. METHODS: The study was retrospective and based on records of children with dentofacial injuries aged below 7 years who were seen in Melaka Hospital between 1 January 2002 and 31 December 2006. RESULTS: During the five years, 268 preschool children were seen and they comprised 8.69% of the total number of dentofacial injuries seen in the hospital during that period. Males outnumbered females by a ratio of 1.8:1. Falls accounted for 83% of the injuries. Soft tissue injuries were the most common injuries encountered (94%) with the lips being the commonest site of injury. Dental injuries were seen in 37% and bone fractures in 3%. CONCLUSIONS: The findings of this study differed in some ways from those conducted in other countries. The findings are useful for resource planning and prevention strategies.
The buccal fat pad in oral reconstruction
Authors: Tahirah S , Mustafa Wan Mahadzir
Published: January 2025

A buccal fat pad (BFP) as a flap for reconstruction of defects in the oral cavity has been described for a variety of conditions. This series reports the use of the buccal fat pad flap in 35 patients for the reconstruction of intraoral defects after tumour resection and traumatic loss of the inferior maxilla from 1996-2007. The flaps were evaluated post-operatively and findings recorded. Thirty two (91%) of the flaps healed without any complications, two developed residual fistula and one was lost to infection. Judicious use of buccal fat pad flap offers a simple, convenient, and reliable way to reconstruct small to medium defects of the oral cavity with low morbidity.
Traumatic Dislocation Of The Mandibular Condyle into The Temporal Fossa in An Adult
Authors: Mustafa Wan Mahadzir , Ahmad Syamsul Anuar
Published: January 2025

A rare case of traumatic anterior dislocation of the mandibular condyle into the temporal fossa is reported. Open reduction using a preauricular approach was used to reduce the dislocation and confirm the adequacy of the reduction. The causative mechanism, diagnostic features, and clinical management are discussed.
Salivary gland tumours in Hospital Kuala Lumpur
Authors: Mustafa Wan Mahadzir , Basri Nornazaliza , Zakaria Abdul Rahim
Published: January 2025

OBJECTIVE:

The purpose of this study was to document the pattern of salivary gland tumours that were treated in Department of Oral and Maxillofacial Surgery, Hospital Kuala Lumpur, during the 10-year period. MATERIAL AND METHOD: Data of 18 patients were retrieved from the operation theatre book and clinical records from the year 2000-2009. The collection of data included presenting symptoms, gender, age, ethnicity, location, histopathology and treatment of the tumour. RESULTS: The most common presenting symptom was swelling. The patients' ages ranged from 16 to 62 years and the peak incidence age of the tumour was in 5th to 6th decade. There was an equal sex distribution. The majority of patients were Malays (55.56%, n=10) followed by Chinese (22.2%, n=4) and the remaining were Indian (11.1%, n=2), Iban(n=1, 1.56%) and Bajau (n=1, 5.56%). Among 18 incident cases, 8 cases were benign and 10 cases were malignant. Of 18 cases, 72.2% (n=13) were from minor salivary gland and the remaining (27.8%, n=5) from major salivary glands. Pleomorphic adenoma was the most prevalent tumour and the only one benign lesion, and mucoepidermoid carcinoma was the most common malignant tumour. The palate was the main site of occurrence of the salivary gland tumour followed by the parotid region. Treatment modality was mainly surgical in both benign and malignant tumors. Combined surgery and radiotherapy were employed in five patients who had adenoid cystic carcinoma, salivary ductal carcinoma, polymorphous low grade adenocarcinoma and adenocarcinoma in the maxilla. Eight of the ten patients presenting with malignant salivary gland tumours survived beyond two years. CONCLUSION: The majority of patients with salivary gland tumours were encountered in the 5th and 6th decades. A higher frequency of salivary gland tumour in Malays than Chinese or Indians was noted. Consistent with reports from the English literature pleomorphic adenoma was the most common salivary gland tumour while mucoepidermoid carcinoma was the most frequently occurring malignant salivary gland tumour.
Malaysian Journal of Oral & Maxillofacial Surgery
Authors: Nabil Syed , Rajandram Rama Krsna , Nordin Rifqah , Jabar Nazimi Abdul
Published: January 2025

Introduction:

The Malaysian Journal of Oral and Maxillofacial Surgery is the official publication of the MalaysianAssociation of Oral and Maxillofacial Surgery. After more than ten years since it was first published, we aim to perform an audit of the publication seen within the journal throughout its history.

Methodology:

All individual articles in the Malaysian Journal of Oral and Maxillofacial Surgery was manually reviewed by the first and second author from its inception to the most recent volume. Data regarding the author's details (state of origin, affiliation, speciality, qualification), study design and articles subject were collected.

Results:

Overall, 58 articles were published in eight volumes. Authors associated with Kuala Lumpur, Ministry of Health and from the oral and maxillofacial specialty were most common when assessed in regards of state of origin, affiliation and specialty respectively. Case report and case series type article were the most common study design while trauma and clinical pathology were the most popular subjects.

Conclusion:

The increase in the publication frequency and the contribution of variety dental and medical-based authors in the journal signals positive signs in which further progress should be targeted in the future.
Palatal flap induced osteoradionecrosis
Authors: Nabil Syed , Rajandram Rama Krsna , Nordin Rifqah , Jabar Nazimi Abdul
Published: January 2025

The palatal rotational flap is a reliable and predictable flap. The pedicled nature of the flap ensures reliable vascular supply. It however leaves a bare donor site which usually heals via secondary intention. However, there is an increased risk of donor site morbidity when applied in a compromised host. The authors report a rare case of an osteoradionecrosis at the donor site following the application of the palatal rotational flap. Caution should be exercised when applying this flap in a compromised tissue.
Oral Cancer Awareness of a Segment of Sabah's Rural Population aged 40 years and above
Authors: Kuan Jeremy Lee Ju , Jalil Norma Abd
Published: January 2025

Objective:

Delay in treatment of oral cancer could be attributed to a general lack of knowledge or awareness in the population. This lack of awareness is even more pronounced among the rural or lower socioeconomic community, which comprises about 60% of the Sabah population. The aim of the study was to determine the level of awareness within this segment of the Sabah population.

Materials and methods:

Questionnaire forms were collected from 164 subjects aged 40 years and above seeking dental treatment at the main dental clinic of 4 major rural centres (Kudat, Kota Marudu, Kota Belud and Keningau) on the west coast of Sabah. The form was divided into a preceding sociodemographic section and a focused question section pertaining to awareness of risk factors, complications, prevention and signs and symptoms of oral cancer. Results obtained were analysed descriptively.

Results and Discussion:

There was no variation in gender with 82 male and 82 female respondents. 70.1% (115 out of 164 respondents) claimed to have previously heard of oral cancer; with an overwhelming 98.2% of them (113 out of 115 respondents) agreed that if left untreated, oral cancer can cause death. There was no significant difference between genders in this respect. Overall, there was a trend for those in the younger age groups and with higher education levels to not only be aware of oral cancer but also the risk factors associated. All 3 pictures shown were successfully identified by more than 75% of all respondents.

Among the centres, Kota Marudu appears to have the lowest awareness about oral cancer with only 52.1% awareness. The highest was Keningau with full awareness among their respondents. This ties in with the fact that Kota Marudu is fairly rural and has the highest proportion of uneducated respondents, whereas Keningau is mostly suburban in nature with a high number of educated respondents.

The majority of the respondents (88.7%) identified smoking as a risk factor, with only 70.4% agreeing that consumption of alcohol is a risk factor. However, only 70.4% and 54.3% of respondents agreed that old age and areca nut chewers respectively are at risk for getting oral cancer.

Conclusion:

This study showed that there is a fairly high level of awareness of oral cancer, its risk factors, prevention and appearance in this particular population group. However, there still exist places such as Kudat and Kota Marudu, which are rural areas with populations having low or no education that showed alarming levels of ignorance to the awareness and prevention of this condition. Although much effort has been spent to spread awareness through both governmental and non-governmental avenues, the effectiveness of these measures have been found wanting possibly to poor focus on at- risk groups. Studies like this can assist in identifying these groups so as to target future preventive or screening programmes to relevant segments of the population.
Sinonasal tuberculosis and Pott's disease
Authors: Rajandram Rama Krsna , Nabil Syed , Nordin Rifqah , Nazimi Abdul Jabar
Published: January 2025

Background:

Skeletal tuberculosis accounts for 10% of cases with extrapulmonary tuberculosis. Sinonasal tuberculosis is rare and has two different pathological types. Pott's disease refers to spinal tuberculosis and is the most common form of skeletal tuberculosis however is often diagnosed late resulting in significant rates of mortality and morbidity among patients.

Case Description:

A 70 year old female presented with a rare case of multifocal skeletal tuberculosis involving the spine and the sinonasal complex. The diagnostic challenge of this case is presented and important clinical points are presented.

Clinical Implications:

High index of suspicion is needed among clinician when dealing with possible rare tuberculous skeletal presentations and a practice of improving early diagnosis using diagnostic tools which are sensitive to detecting skeletal tuberculosisis.
Subclavicular Route for Pectoralis Major Myocutaneous Flap
Authors: Yahiya Mohammad Adzwin , Din Shah Kamal Khan Jamal , Hamdan Mukhriz , Jin Victor Ooi Keat
Published: January 2025

The aim of this paper was to discuss the risks and benefits of subclavicular route through literature review and to report our novel experience. Pectoralis major myocutaneous flap (PMMF) has always been the mainstay in the immediate reconstruction of defects of the head and neck region, despite recent advances in microvascular surgical techniques and the development of several free flaps. This is particularly so in those services where free flaps are not routinely available. The tissue is abundant with an excellent axial vascularization by the thoracoacromial artery. Its anatomic proximity facilitates the immediate reconstruction of a variety of defects in the head and neck area. Several modifications regarding the original technique have been published. Among these technical modifications, the subclavicular route for PMMF transfer to the head and neck region has been widely adopted by many surgeons. This is because the supraclavicular route can be problematic due to excessive bulk of the tissue and a limited arc of rotation. Some authors consider that this modification may compromise the flap. Due to the narrow space between the clavicle and the subclavian vessels, the passage of the PMMF under the clavicle may not be an easy manoeuvre. Subclavicular approach decreases the bulk of the flap pedicle which is functionally and cosmetically favourable. Subclavicular approach may be a difficult manoeuvre that could put the neurovascular bundle and the integrity of the vascular pedicle at risk. Sound knowledge on technique and anatomy is important. Indication should be evaluated on a case-by-case basis.
Technique for Fixation of the Frost Suture in Correction of Ectropion
Authors: Yahiya Mohammad Adzwin
Published: January 2025

Ectropion is an abnormal eversion (outward turning) of the lid margin away from the globe. Without normal lid globe apposition, corneal exposure, tearing, keratinization of the palpebral conjunctiva, and visual loss may result. Ectropion and excess sclera show are complications that can arise after blepharoplasty, trauma of the lower eyelid, or operations using subciliary incisions. Recently, the author managed a case of postoperative ectropion using fixation of the Frost Suture described by Murphy and Bradrick. The result of the case was very encouraging, as reported here.
Retromandibular Transparotid Approach to Subcondylar Fractures
Authors: R Parumo , BC Ma , R Sujak , A Jelon
Published: January 2025

Aim:

To evaluate the surgical morbidity and efficiency of retromandibular transparotid approach in the management of subcondylar fractures in comparison with the other studies and also to evaluate the stability of different type of rigid fixation system used.

Method:

This retrospective clinical study comprises a total of 29 patients with 33 condylar fractures that were operated using retromandibular transparotid approach between January 2010 and December 2013. Postoperative complications and outcomes were evaluated at a minimum of 3 months and compared with the other studies. All surgical scars were assessed after 3 months. The surgical time was recorded intraoperatively and the stability of the rigid fixation systems was evaluated radiographically.

Result:

There was no major complication in all cases. There were 2 cases (6%) of temporary facial nerve palsy which resolved after 3 weeks. All surgical scars were barely visible after 3 months. There is no fracture or loosening of screws with any of the 3 different plates used.

Conclusion:

The non aggrasive retromandibular transparotid approach is a safe and efficient surgical method of ORIF (open reduction with internal fixation) of subcondylar fractures of the mandible. It provides direct visual access to the fracture site with satisfactory functional outcome and low morbidity. It allows the correct placement of the miniplates and screw which lead to a stable osteosynthesis of subcondylar fractures.
Sternocleidomastoid Myocutaneous Flap for Floor of Mouth Reconstruction after Resection of Squamous Cell Carcinoma
Authors: Yahiya Mohammad Adzwin , Ji Tong , Zhang Chen-Ping
Published: January 2025

The sternocleidomastoid (SCM) muscle has been used as a myocutaneous flap where a skin paddle is taken over from the lower aspect of the muscle to satisfy the need for viable soft tissue in the reconstruction of oral cavity defects. The flap is not regularly used because it has been criticized on oncologic grounds, which are related to the safety of preserving this muscle when there are regional lymphatic metastases, unreliability of the skin paddle, limited size of the musculocutaneous unit, poor arc of rotation and introduction of free tissue transfer. The blood supply of the muscle is segmental in nature. Superior pedicle based flap is frequently used and the lower arterial pedicle is sacrificed to gain the full length of the muscle. The oral part of the skin undergoes partial or total necrosis as the skin paddle receives its blood supply from a segment which is very far from the superior arterial pedicle. The success rate of SCM myocutaneous flap can be improved by preserving the branch from the superior thyroid artery. The anatomic and technical basis of the flap is discussed in the context of a safe and reliable single-stage pedicled flap transfer in oral and maxillofacial reconstructive surgery.