Introduction: Cone beam computed tomography (CBCT) has gained interest for improving diagnosis, treatment planning and facilitating better patient’s management in various dental fields. This study is part of the quality assurance programme in Dental Faculty, International Islamic University Malaysia (IIUM). This center offers dental radiography service not only for internal clinics but also act as a referral center for the eastern areas, Pahang, Malaysia. Aims: The aims of this study were; 1) to assess referral pattern for CBCT scans at the Dental Faculty, IIUM, Kuantan, and 2) to evaluate the completeness of the current referral form used by clinicians (for both internal and external referrals). Methods: An audit looking at both the external and internal referral CBCT forms of a four year period of examination (2010-2013) at the Radiology Unit, Dental Faculty, IIUM. Source of referrals, indications for CBCT and the referral forms were examined and analysed. Results: Total CBCT scans taken within the four-year period were 171, in which 96 were referred from internal sources whilst 75 were external referrals. External referrals were mainly from Paediatric Dentistry and Orthodontic clinics (59%), while other referrals were from implant clinic (20%), Paediatrics and Special Needs clinic (15%), Oral MaxilloFacial Surgery clinic (4%) and Periodontic clinic (1%) and Oral Medicine Oral Pathology (OMOP) clinics (1%). All forms from external sources are completely filled. In the Internal referral form, 41% of them came with no indication of why CBCT need to be taken. Out of 59% of cases with indications, 33% came from Paediatric Dentistry and Orthodontic department, followed by Oral Surgery department (10%). Implant treatment planning accounted for 7% of cases, Periodontics 4%, Temporo-Mandibular Joint assessment 2%, 1% for Conservative dentistry and Prosthodontic cases respectively and 1% cleft case. Further analysis of the internal referral forms revealed that only 14% of the forms were filled with complete patients’ details, 40% specified pregnancy status and 67% clearly stated patients’ medical status. Area of interest was not specified in 69% of cases and clinicians’ names were not stated in 94% of the cases. Majority of the forms were completed with clinicians’ signature (99%) and also radiographers’ details (97%). Conclusions: This study indicated that the majority of IIUM CBCT referrals were from internal sources. However, most of the referral forms were not completely filled. The internal form used, therefore, need to be improved and a much firmer referral framework should be in place.
Rajakumar MK, Suleiman AB, Lee CH, Cheah M, Yeoh PH
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Citation: Mohd Sidik S. Mental Health in the Community - Malaysia: A 20-Year Journey of a Family Medicine Consultant. Serdang: Universiti Pura Malaysia Press; 2017
Sixteen topsoil samples from Bukit Jernih, Gua Kelam and Bukit Merah were analysed for their major elements and heavy metal composition, together with several physico-chemical parameters. Major elements determined were SiO2, TiO2, Al2O3, Fe2O3, MnO, MgO, CaO, Na2O, K2O, P2O5, whereas heavy metals determined were As, Co, Cu, Cr, Ni, Pb and Zn. Physico-chemical parameters determined were percentage of organic matter, clay, silt and sand composition, pH and electrical conductivity. The results showed that the average soil pH in limestone soil was between 6.38 to 6.93, whereas average soil pH in quartzite soil was 6.23. The average soil electrical conductivity for all sampling stations was below 1.7 mScm-1. High organic matter content average was shown in soil samples from Bukit Jernih (7.45%), followed by Gua Kelam (5.21%) and Bukit Merah (3.31%). Soil samples from Bukit Jernih and Gua Kelam showed a clayey texture with more than 35% clay content, whereas soil from Bukit Merah was sandy in texture with more than 67% sand content. In general, soil samples from limestone area of Bukit Jernih and Gua Kelam recorded higher content of heavy metals compared to quartzite soil from Bukit Merah. The average concentration of Cr and Co at Bukit Jernih at 413 µg/g and 88 µg/g, respectively, whereas the concentration at Gua Kelam was 152 µg/g dan 76 µg/g. These concentrations exceeded the potential toxic concentration in soil. The main major elements were SiO2 followed by Al2O3 and Fe2O3. SiO2 content in quartzite soil from Bukit Merah(89.45%) was higher compared to limestone soil from Bukit Jernih (59.74%) and Gua Kelam (53.16%). Nevertheless, Al2O3 and Fe2O3 content in limestone soil was higher compared to quartzite soil. The percentage of easily ignited content in limestone soil was two fold higher than quartzite soil. Other major elements were less than 2.5%. The study showed that enrichment of Cr, Zn, Pb, Ni and Cu in soil was influenced by the presence of SiO2, Al2O3 and Fe2O3.
Keywords: Enrichment; heavy metals; limestones hill; major elements; toxicity
Sediment cores were taken at eight stations along Sarawak and Sabah coastal waters using a gravity box corer on July 2004. The sediment cores were cut into 2 cm interval for measurement of Mn and Fe concentration using the Inductive Couple Plasma-Mass Spectrometer (ICP-MS). Overall, the sediment cores contained much mud which include a mixture of silt (46 – 67%) and clay (18 – 53%) compared to sand (0.4 – 16%). The concentrations of Mn and Fe were in the range of 154 – 366 µg/g and 0.9 – 3.4%, respectively. The variation was studied by ANOVA, which showed a significant difference (p = 0.000) for both of Mn and Fe concentrations at all sampling stations. In those ranges, Fe concentration was higher compared to Mn. It is believed that dissolving and diluting process influenced the concentration of Mn in the water column and sediment. Fe showed a significant correlation (r > 0.5, p < 0.01) with Mn at all stations except SR 03, indicating the natural occurrence of Mn and Fe in the water column. Meanwhile, Müller classification proved that sediment cores taken at 8 stations along Sarawak and Sabah coastal waters were not polluted with Fe and Mn with geoaccumulation index, Igeo < 1 and classification 0 – 1.
Keywords: Fe; Mn; Müller classification; organic carbon; particle size; sediment core