Maxillary molar teeth may have accessory roots. The aim of this paper is to review and discuss the endodontic implications of this anatomical variation. A review of the literature was undertaken to identify studies and reported cases where accessory roots have been recorded in maxillary molar teeth. The results show that although the prevalence of accessory roots in maxillary molar teeth is low, they can exist in all three types of maxillary molar teeth, and they may be located palatally, buccally, mesially or distally. Hence, it is essential that dentists undertaking root canal treatment thoroughly assess all teeth to determine how many roots are present in order to provide the best possible outcome of treatment for the patient.
Pericardial cysts are uncommon mediastinal lesions that are usually congenital in origin. Patients are usually asymptomatic and the cysts are generally discovered on routine radiography for unrelated purposes. This case illustrates a symptomatic presentation of a haemorrhagic pericardial cyst in which radiographic, echocardiographic and multislice (MRI and CT) imaging were performed. The imaging findings were not typical of pericardial cysts leading to a diagnostic quandary despite the varied imaging techniques. In conclusion, it is important to appreciate that the imaging findings of pericardial cysts can be varied. Radiologists and clinicians alike should be aware of this variability.
Cervical translaminar screw fixation has been shown to be safe, efficient and provides alternative for cervical fixation. However, its use in the Asian population should be considered cautiously because the cervical lamina diameter may not be adequate to accommodate the standard lamina screw size. We studied the average transverse lamina diameter of the cervical spine in the Malaysian population to evaluate the feasibility and safety of lamina screw fixation in this population.
The mandibular incisive nerve can be subjected to iatrogenic injury during bone graft harvesting. Using cone beam computed tomography (CBCT), this study aims to determine a safe zone for bone graft harvesting that avoids injuring this nerve.
Operative treatment for neglected fracture of lateral humeral condyle (LHC) is difficult because of contracted muscle, fibrous tissue formation, and indistinct bony edges. Its success depends on the ability to preserve blood supply during the surgery. We retrospectively reviewed eight cases of neglected fracture of LHC in children treated with open reduction with selected multiple 'V' lengthening of common extensor muscle and internal fixation. The patients were between 3 and 8 years of age. The period of neglect was between 3 and 20 weeks. Four patients with displacement of more than 10 mm and neglect for 5 weeks or more required lengthening of common extensor muscle aponeurosis. The follow-up assessments were between 1 and 6.3 years with a mean of 4.4 years. All patients had union by 2 months. They gained improvement of flexion range of motion between 60° and 120° with a mean of 86.3°. Loss of final range of motion compared with the normal side was between 5° and 35° with a mean of 10°. No patient had limitation of activities or pain. Six cases had excellent and two cases had good Dillon functional score. All patients had lateral condyle prominent with different severities. There was one mild avascular necrosis and one fishtail deformity. Both of them had almost full range of motion. All patients had early physeal closure, except one, who had only 1 year follow-up. There was no case of progressive valgus deformity. Children with neglected fracture of LHC would benefit from anatomical reduction and internal fixation through a proper exposure and if indicated combined with multiple 'V' lengthening of common extensor muscle aponeurosis. This is a level IV study.
A man, 56 years of age, presents to his general practitioner after coughing up half a cupful of fresh, bright red blood every day for 1 week. He has no other medical complaints. He reports previous pulmonary tuberculosis 12 years ago treated with 6 months of standard therapy. Routine follow up was discontinued after 5 years after no evidence of reactivation. He is a nonsmoker, does office clerical duties and is not known to have diabetes or hypertension.
Curcuma longa (CL) or turmeric is an Ayurvedic herb that has been traditionally used to treat inflammatory conditions like rheumatoid arthritis (RA). Collagen-induced arthritis (CIA) is a well established experimental auto-immune mediated polyarthritis in susceptible strains of rodents. The main aim of the study was to observe the inflammatory, macroscopic and radiological changes in the arthritic ankle joints of experimentally collagen-induced arthritis animals treated with or without CL extract.
Orbital myositis in children is uncommon. Recurrence is a major challenge in management. An 11-year-old Malay girl who presented with bilateral orbital myositis with recurrent attacks of diplopia is reported.
Sturge-Weber syndrome is a neurocutaneous syndrome characterised by facial port wine stain, ipsilateral leptomeningeal angioma and vascular eye abnormalities. We report a rare case of Sturge-Weber syndrome without facial nevus presenting with neonatal seizures.
BACKGROUND: One of the most commonly used method for dental age assessment is the method reported by Demirjian and coworkers in 1973. It was later modified by Willems and coworkers whereby they “performed a weighted ANOVA” in order to adapt the scoring system.
AIM: To evaluate the applicability of Demirjian and Willems methods for dental age estimation for Malaysian children and to correlate the accuracy of the findings with the chronology of tooth development of premolars and second molars.
MATERIALS AND METHODS: A total of 991 dental panoramic radiographs of 5-15-year-old Malaysian children were included in the study. The mean Demirjian and Willems estimated ages were compared to the mean chronological age.
RESULTS: The mean chronological age of the sample was 10.1±2.8 and 9.9±3.0 years for males and females respectively. Using the Demirjian method, the mean estimated dental age was 10.8±2.9 years for males and 10.5±2.9 years for females. For Willems method, the mean estimated age was 10.3±2.8 years males and 10.0±3.0 years respectively.
CONCLUSIONS: Willems method was more applicable for estimating dental age for Malaysian children. Overestimation in Demirjian method could be due to advanced development of second bicuspids and molars.
Matched MeSH terms: Radiography, Panoramic; Radiography, Dental, Digital
Interventional cardiology (IC) procedures are known to give high radiation doses to patients and cardiologists as they involve long fluoroscopy times and several cine runs. Patients' dose measurements were carried out at the cardiology department in a local hospital in Penang, Malaysia, using Gafchromic XR-RV2 films. The dosimetric properties of the Gafchromic film were first characterised. The film was energy and dose rate independent but dose dependent for the clinically used values. The film had reproducibility within ± 3% when irradiated on three different days and hence the same XR-RV2 dose-response calibration curve can be used to obtain patient entrance skin dose on different days. The increase in the response of the film post-irradiation was less than 4% over a period of 35 days. For patient dose measurements, the films were placed on the table underneath the patient for an under-couch tube position. This study included a total of 44 patients. Values of 35-2442 mGy for peak skin dose (PSD) and 10.9-344.4 Gy cm(2) for dose-area product (DAP) were obtained. DAP was found to be a poor indicator of PSD for PTCA procedures but there was a better correlation (R(2) = 0.7344) for CA + PTCA procedures. The highest PSD value in this study exceeded the threshold dose value of 2 Gy for early transient skin injury recommended by the Food and Drug Administration.
A cross sectional study of thoracic pedicle morphometry in the immature spine of Malaysian population using reformatted computed tomographic (CT) images.
BACKGROUND AND AIMS: Many patients who presented to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with signs and symptoms of urolithiasis had mild hydronephrosis with non visualization of calculus on ultrasound examination. These patients underwent an intravenous urogram (IVU) in order to determine the presence of urolithiasis and most of them had normal IVU. The main aim of this study was to determine the predictive value of urinalysis in this group of patients in determining the need for IVU examinations.
MATERIALS AND METHODS: Retrospectively the ultrasound, urinalysis and intravenous urography reports of 53 patients were reviewed and evaluated.
RESULTS: The positive predictive and negative predictive value of urinalysis was found to be 68% and 96.4%, respectively. CONCLUSIONS; The results indicate that the urinalysis was an excellent negative predictor for IVU. In view of high radiation dose, risk of contrast reaction and contrast induced nephropathy of IVU, we suggest that it should not be performed in patient with non visualization of calculus mild hydronephrosis when the urinalysis is negative for blood.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
This paper presents an approach for breast cancer diagnosis in digital mammogram using curvelet transform. After decomposing the mammogram images in curvelet basis, a special set of the biggest coefficients is extracted as feature vector. The Euclidean distance is then used to construct a supervised classifier. The experimental results gave a 98.59% classification accuracy rate, which indicate that curvelet transformation is a promising tool for analysis and classification of digital mammograms.
To study the morphological difference between the lumbar pedicle in adolescent and adult groups as only less information is known about their pedicle morphology, especially in Malaysian population.