A pilot study of risk factors in cleft lip/palate patients in Kelantan

About 2-3% of pregnancies result in neonates with serious genetic diseases or birth defects causing disabilities, mental retardation, and in some cases early death. Non-syndromic cleft lip and palate (CLP) is a common craniofacial anomaly affecting between lin 700 and 1 in 1000 births in the UK and USA respectively. In Malaysia, studies of school children showed the incidence of 1 in every 941 subjects examined. The risks of non-syndromic cleft lip with or without cleft palate and isolated cleft palate (CLP) are influenced by variations at several loci of the gene and these loci interact with environmental factors to determine disease risk.The aim of the study is to establish the relationship between risk factors and incidence of cleft lip and palate and further enhance research activities in finding specific genetic factors that are sensitive to the risk factors.This is a case controlled study of non-syndromic CLP patients attending combined clinic in Kota Bharu and patients attending outpatient clinic in HUSM. Information was obtained by interviewing parents using questionnaires. Patients attending CLP clinic were first interviewed. The age of the control group was restricted to age. Univariate and multiple logistic regression analysis were used to analyze the data.More than 90% of the subjects are Malays from lower socio-economic status. It was found that demographically there are variations to risks of non-syndromic CLP. People from Tanah Merah and Tumpat are 8.74 fold increase risk compared to people from Kota Bharu. There is association between passive smokers and CLP(OR)= 2.45(95% CI: 1.5,3.94). Maternal and paternal history of cleft, occupation of father and position of child in the family increase the risk of CLP (p=0.009).The study suggested that there are some geographical variations in the risk of CLP. Copper et al (2000) believed that the variation could indicate environmental factors such as seasonal availability of nutrients, infectious disease circle and vitamin deficiency during pregnancy. Exposure to cigarette smoke (passive smokers) is shown to increase the risk of CLP. This is consistent with the findings of Wyszynski et al (1997).The seventh child and above have increased risk of CLP. This could be due to increased maternal age as consistently in other studies.This analysis suggests a small but statistically significant association between maternal cigarette smoking during the first trimester of gestation and increased risk of having child with CLP

Tooth Wear Prevalence and Sample Size Determination : A Pilot Study

Tooth wear is the non-carious loss of tooth tissue, which results from three processes namely attrition, erosion and abrasion. These can occur in isolation or simultaneously. Very mild tooth wear is a physiological effect of aging. This study aims to estimate the prevalence of tooth wear among 16-year old Malay school children and determine a feasible sample size for further study. Fifty-five subjects were examined clinically, followed by the completion of self-administered questionnaires. Questionnaires consisted of socio-demographic and associated variables for tooth wear obtained from the literature. The Smith and Knight tooth wear index was used to chart tooth wear. Other oral findings were recorded using the WHO criteria. A software programme was used to determine pathological tooth wear. About equal ratio of male to female were involved. It was found that 18.2% of subjects have no tooth wear, 63.6% had very mild tooth wear, 10.9% mild tooth wear, 5.5% moderate tooth wear and 1.8 % severe tooth wear. In conclusion 18.2% of subjects were deemed to have pathological tooth wear (mild, moderate & severe). Exploration with all associated variables gave a sample size ranging from 560 – 1715. The final sample size for further study greatly depends on available time and resources

Prevalence of Oral Mucosal Lesions in Patients with Type 2 Diabetes Attending Hospital Universiti Sains Malaysia

Objectives: Diabetes mellitus is associated with a greater likelihood of developing certain oral mucosal disorders. This study was aimed at assessing the prevalence of oral mucosal lesions (OMLs) in patients with type 2 diabetes (DM2) and to investigate the association of such lesions with metabolic control of the disease. Methods: This cross-sectional study involved 391 patients with DM2 and 391 non-diabetic control subjects. Demographic information and data on the duration and type of diabetes, glycosylated hemoglobin (HbA1c) values, medical history, and current use of medication were obtained from medical records. Detailed oral examination was performed in accordance with international criteria. Results: The prevalence of OMLs was significantly higher among diabetic patients (45.5%) than among control subjects (38.4%) (P = 0.042). Patients with diabetes had a higher prevalence of geographic tongue (GT) (P = 0.017), denture stomatitis (P = 0.018), and angular cheilitis (P = 0.006) than controls. Overall, diabetic patients with poor metabolic control had a significantly higher prevalence of OMLs and xerostomia than patients with moderately and well-controlled disease (P < 0.05). Conclusions: The prevalence of OMLs was significantly higher in diabetic patients than in control subjects. Higher occurrence of OMLs was significantly associated with poor metabolic control