Pattern of Oral and Maxillofacial New Referrals During COVID-19 Lockdown

ABSTRACT@#The study aimed to quantify the impact of lockdown during the COVID-19 pandemic on new case referrals to the Oral and Maxillofacial Surgery (OMS) service. The researchers retrospectively reviewed all new referrals received during a government-imposed 47-day lockdown period and a similar period pre-lockdown as a control group. The main outcome was the differences in the number of new case referrals between the two periods. The contributing clinical and demographic factors were also explored. Appropriate bivariate statistics were computed and the level of significance was set at 0.05 for all tests. A total of 309 referrals were received during the study period. There was a reduction of new referrals due to the lockdown from five to two cases per day. There was a statistically significant reduction of cases referred from outpatient and emergency departments. There was also a statistically significant difference with regard to home address distance to the centre. Medically compromised and orofacial infection referrals were not affected by lockdown. The lockdown imposed due to the pandemic has significantly impacted the pattern of new OMS referrals. Referrals for orofacial infections, the medically compromised and inpatients were minimally affected by lockdown.

Association of ABO blood groups with diabetes mellitus

So far no studies have been performed in Malaysia to look at association of diabetes mellitus [DM] with blood groups. We studied the association of ABO blood groups with DM type 2. It was a case control study conducted at Kepala Batas Hospital Batas, Penang, Malaysia in the year 2009, involving 70 patients with DM type 2 and 140 healthy controls. Ethical approval was obtained from Universiti Sains Malaysia. Blood samples were collected from the patients after consent. Samples were tested for ABO blood groups using ID-Card gel method. Chi-square test results showed that there was an association between the ABO blood groups and DM type 2. It was found that A and O blood groups were negatively associated with DM type 2 [P<0.05] with higher percentage of A and O groups individuals were non-diabetic. No significant association was noted between DM type 2 and blood groups B [P=0.423] and AB [P=0.095]. It was also noted that B blood group was distributed with highest percentage among patients with DM type 2 [53.71%] compared to controls [22.52%], but no statistical significance achieved. The results obtained suggest that there was a negative association between ABO blood groups A and O with DM type 2, with A and O group having less chances of diabetes. Large studies in other ethnic groups are needed to confirm these results

Mediterranean glucose-6-phosphate dehydrogenase [G6PD[c563t]] mutation among jordanian females with acute hemolytic crisis

To evaluate the G6PD[c563t] Mediterranean mutation among Jordanian females who were admitted to Princess Rahma Teaching Hospital [PRTH] with/or previous history of favism. A descriptive study. Jordanian University of Science and Technology and PRTH, from October 2003 to October 2004. After obtaining approval from the Ethics Committee of Jordanian University of Science and Technology, a total of 32 females were included in this study. Samples from 15 healthy individual females were used as a negative control. Blood samples from these patients were collected and analyzed by allele-specific polymerase chain reaction [AS-PCR] to determine the GGPDcsesr mutation. Twenty one out of 32 patients were found to be G6PD[C563t] Mediterranean mutation [65.6%] positive. Three out of 21 patients were homozygous and remaining 18 were heterozygous for G6PD[C563t] Mediterranean mutation. Eleven [34.4%] out of 32 patients were found to be negative for G6PD[C563t] mutation indicating the presence of other G6PD mutations in the study sample. G6PDC563T Mediterranean mutation accounted for 65.6% of the study sample with favism in the North of Jordan. There is likely to be another G6PD deficiency variant implicated in acute hemolytic crisis [favism]

High frequency of hand foot syndrome with capecitabine

A hospital based cross-sectional retrospective study was conducted to determine the frequency of hand foot syndrome [HFS] with Capecitabine as a single agent and in combination with Oxaliplatin. The study included 43 consecutive cases of colorectal carcinoma and conducted from June till December 2008. Patients on palliative care were excluded. SPSS was used for the application of chi-square test, by keeping the level of significance as p<0.05. Fifteen [34.9%] patients developed HFS, 10 in the single-agent and 5 in the combination group. No significant association of HFS with either regimens was noted [p=0.876]

Association of carcinoma breast: grade and estrogen progesterone receptor expression

To determine the association between histological grade of tumour and estrogen progesterone receptors [ER/PR] expression in unselected invasive carcinoma of breast in Malaysian patients. An observational study. Advanced Medical and Dental Institute and Hospital, Kepala Batas, from year 2002 to 2007. Ethical approval from Ministry of Health of Malaysia was obtained. Retrospective case records of patients presented between 2002- 2007 were reviewed for obtaining information on grade of tumour and expression of ER/PR in unselected carcinoma of breast patients. Records with missing data were discarded. Out of 195 cases evaluated, 42 cases of grade-l tumour were recorded of which 08 [19%] tested positive for ER and 34 [81%] tested negative, 86 cases represented grade-ll tumour of which 33 [38%] tested positive for ER and 53 [62%] were negative for ER, while out of 67 grade-Ill tumours 22 [33%] were positive for ER receptors while 45 [67%] were negative, [chi[2] statistic [df] 4.831, p=0.089]. For PR, 192 cases were evaluated and data was missing for 3 cases on PR status. Grade-l tumour consisted of 39 cases of which PR +ve represented 07 [17.94%] and 32 [82.05] cases PR -ve; 86 cases were of grade-ll of which 31 [36.04%] were PR +ve and 55 [63.95%] PR -ve. Sixty seven cases of grade-Ill tumour of which 19 [28.35%] were PR +ve and 48 [71.64] were PR -ve [chi[2] statistic [df]: 4.297; p=0.117]. ER/PR positivity trend was highest for grade-ll tumours compared to grade-l and grade-l 11 tumours. In general ER positivity was more with grade-ll and grade-Ill tumours compared to grade I tumours. Although results did not reach statistical significance but there was a trend towards ER/PR positivity in grade-ll and III tumours. So far, studies from South East Asia reported ER/PR expression more with low grade tumours

Age specific histologic types of carcinoma breast in Malaysians

The influence of age on various histological types of breast cancer at both age < 50 years and > 50 years to simulate menopause was studied retrospective from 2002 to 2004 in Malaysia. One hundred and fifty five cases were reviewed. Ninety two cases recorded at age < 50 years, 60 [65.2%, 95%CI: 54.6 - 74.8%] were infiltrating ductal carcinoma in 11[12.0%, 95% CI: 6.1-20.4%], ductal carcinoma in situ [DCIS] in 9 [9.8%, 95% CI: 4.6-17.8%], medullary carcinoma in 6 [6.5%, 85%CI: 2.4-13.6%], invasive lobular carcinoma in 4 [4.3%, 95%CI: 1.2-10.8%], mucinous carcinoma and poorly differentiated carcinoma in 2 cases [2.2%, 95%CI: 0.3-7.6%]. At > 50 years of age, 63 cases were recorded. Forty seven [74.6%, 95%CI: 62.0- 84.7%] cases were of infiltrating ductal carcinoma, ductal carcinoma in situ in 9 [14.3%, 95%CI: 6.7-25.4%], mucinous carcinoma in 5 [7.9%, 95%CI: 2.6-17.6%], medullary carcinoma [8.5%] and papillary carcinoma in 1 case each [1.6%, 95%CI: 0.0-8.5%]. Infiltrating ductal carcinoma was the commonest histology at both age < 50 years and > 50 years

Association of ABO blood group b with myocardial infarction

The purpose of this study was to find out the association between blood group B and Myocardial Infarction [Ml] in sample population in Malaysia. A case-control study. The study was conducted at Hospital Kepala Batas, Penang, Malaysia, from 2006 to 2007. The study was approved by the Research and Ethics Committee, School of Medical Sciences, University Sains Malaysia. The study included 170 patients with confirmed Ml as cases and 170 subjects without Ml were taken as controls. After ethical approval, patients were recruited for the study from Hospital Kepala Batas after informed consent. Blood sample around 2 ml was collected from each patient and control. Each blood sample was tested by ABO gel card test for the blood group. Sample size was calculated using a power and sample size software, whereby power of study was 80%, Confidence Interval [Cl] was 95%, odds ratio was 2 and ratio of control to case was 1. Odds ratio and the Cl were used to describe the association between Ml and group B. A total of 170 Ml patients and 170 controls were tested for ABO blood groups. Statistical analysis showed that among 170 Ml subjects, 54 [31.8%] were blood group B and among 170 controls, 51 [30%] were blood group B. Simple logistic regression analysis showed no association of Ml with blood group B [p=0.824, crude OR 0.95, 95% confidence interval 0.62-1.47]. Multiple logistic regression analysis also did not show association of blood group B with Ml [p=0.222, adjusted OR 0.68, 95% confidence interval 0.37-1.26]. This study failed to demonstrate any association of blood group B with Ml in sample population in Malaysia compared to few studies reporting positive association, however, we suggest further studies to elaborate on this finding in Malaysian population

Hereditary spherocytosis in a Malay patient with chronic haemolysis

This case report describes a 35-year-old lady who presented with generalized weakness and lethargy of two weeks duration and jaundice of more than 20 years duration. Her initial workup was suggestive of haemolysis and blood film showed a leucoerythoblastic picture with moderate microspherocytes. She was finally diagnosed as a case of hereditary spherocytosis after ruling out other possible causes of chronic haemolysis and supported by an abnormal osmotic fragility test, although family members refused for screening. Hereditory spherocytosis is uncommon in Malay population and presentation with jaundice of 20 years duration with leucoerythroblastic picture on blood film were interesting features in this case. Patient is being followed closely for need of splenectomy in near future as per severity of haemolysis and currently being managed with folic acid supplement.

Bone involvement in hodgkin's disease at presentation: a series of three case reports with a brief review

Most patients with Hodgkin's lymphoma present with the disease. On staging workup, all the three patients progressive painless lymphadenopathy. Very few patients were found to have bony lesions at the time of diagnosis, have presented with bony involvement at the time of confirmed by imaging studies. All patients were treated diagnosis. We report on three cases of Hodgkin's with chemotherapy and radiotherapy directed at their lymphoma who presented with signs and symptoms of bony lesions. bone involvement in addition to other clinical features of the disease on rtaging work up, all the three patients were found to have bonylerions at the time of cliagnosin confivmed by imaging rtudgies. all patients were treated with chemotheraby and radio theraty directed at their bany lesions