Normastura Abd Rahman

The effect of mild hearing loss on academic performance in primary school children

OBJECTIVES To determine the prevalence of mild hearing loss and its association with academic performance among primary school children. PATIENTS AND METHODS A comparative cross sectional study was conducted on standard (grade) five school children in a state in Malaysia. Five schools were selected by using simple random sampling. There were three classes (A, B and C) of standard five in each school. Students selection into these classes was made by respective school administration based on their final term examination in standard four. Class A was for the best academic achievers while class C was for the poorest. Ear examinations were done followed by pure tone audiometry for confirmation of the hearing status. In this study, mild hearing loss was defined as an average threshold of 20-39 dB at 0.5, 1, 2 and 4 kHz. Data analysis was done using SPSS Version 12.0 software. Chi-square test was used to determine the association between mild hearing loss and academic performance. The significant level was set at p=0.05. RESULTS From a total of 257 students, 234 have completed the examinations (response rate=91.0%). Fifty-three percent of them were boys while 47% were girls. A hundred and forty-nine (63.7%) of them were from class A while 85 (36.3%) were from class C. The prevalence of hearing loss in our school population was 15% (95% CI: 11.0-20.0%). Thirty-two (88.9%) of them were having conductive type. Out of the total, 38.9% were having problems in both ears. The students who have poor academic performance have been shown to be significantly associated with mild hearing loss (p<0.001). CONCLUSIONS There was a high prevalence of mild hearing loss among primary school children. This problem could affect their academic performance. Therefore, hearing assessment is highly recommended to be done on every child especially to those who have poor academic achievement.

Mutation detection in GJB2 gene among Malays with non-syndromic hearing loss

OBJECTIVES To identify the mutations in the GJB2 gene and to determine its association with non-syndromic hearing loss in Malays. METHODS A comparative cross sectional study was conducted on a group of children from the deaf schools and the normal schools. A total of 91 buccal cell samples of non-syndromic hearing loss and 91 normal hearing children were taken. Polymerase chain reaction was used to amplify the coding region of GJB2 gene. The PCR product of GJB2 coding region was preceded with screening for mutations using denaturing high performance liquid chromatography (dHPLC) and mutations detected were confirmed by DNA sequencing. RESULTS Twelve sequence variations including mutations and polymorphisms were found in 32 patients and 37 control subjects. The variations were G4D, V27I, E114G, T123N, V37I and R127H in both groups, W24X, R32H, 257_259 del CGC and M34L in patients only and I203T and V153I in control subjects only. There were no association between homozygous (P=0.368) or heterozygous (P=0.164) GJB2 gene and non-syndromic hearing loss. CONCLUSIONS The types of GJB2 gene mutation were different and vary in Malay non-syndromic hearing loss as compared to the other races. Furthermore, the mutation did not associate with hearing loss in the population. Other related genes are believed to be involved and need to be sought in this group of patients.

The performance of distortion product otoacoustic emissions and automated auditory brainstem response in the same ear of the babies in neonatal unit

OBJECTIVE To identify the outcomes of hearing screening using different protocols of both Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR) tests in the same ear of the babies in a neonatal unit population. METHODS A cross-sectional study was carried out on babies who were admitted into a neonatal unit. By using a formula of single proportion and considering 20% drop out, the number of sample required was 114. The subjects were chosen by using a systematic random sampling. The infants selected were subjected to DPOAE followed by AABR tests screening at the same setting before discharge. RESULTS There were 73 newborns (61.6% male and 38.4% female) participated in this study with a total of 146 ears screened. Ototoxic medication was the most common risk factor followed by hyperbilirubinaemia and low birth weight. AABR had higher passing rate (82.9%) as compared to DPOAE (77.4%). The highest passing rate was achieved if the protocol of either passed DPOAE or AABR was used (90.4%). The rate was lower when auditory neuropathy spectrum disorder (ANSD) has been considered (82.9%). Hyperbilirubinaemia, prematurity, craniofacial malformation and ototoxic drugs seem to be the high risk factors for auditory neuropathy. CONCLUSION AABR has a higher passing rate as compared to DPOAE. However, the use of both instruments in the screening process especially in NICU will be useful to determine the infants with ANSD who may need different approach to management. Therefore, a protocol in which newborns are tested with AABR first and then followed by DPOAE on those who fail the AABR is recommended.

Screening of Transforming Growth Factor Beta 3 and Jagged2 Genes in the Malay Population With Nonsyndromic Cleft Lip With or Without Cleft Palate

Objective To determine the prevalence of mutations in transforming growth factor beta 3 (TGFβ3) and Jagged2 genes and their association with nonsyndromic cleft lip with or without cleft palate (CL±P) patients. Design Cross-sectional study on nonsyndromic CL±P and noncleft patients. Setting Reconstructive clinic and outpatient dental clinic, Hospital Universiti Sains Malaysia. Patients Blood samples of 96 nonsyndromic CL±P and 96 noncleft subjects. Main Outcome Measure Prevalence and association of mutations in TGFβ3 and Jagged2 genes with nonsyndromic CL±P. Results Most of the nonsyndromic CL±P patients (53.1%) had left unilateral CLP. There were slightly more females (56.6%) compared with males. The prevalence of the mutations in the TGFβ3 gene was 17.7% (95% confidence interval [CI]: 9.5, 24.5) and in the Jagged2 gene was 12.5% (95% CI: 5.5, 18.5), which was higher compared with the noncleft group. For the TGFβ3 gene, there was no mutation in the coding region in either of the groups. All variants were single nucleotide polymorphisms located within the intronic flanking region. Two variants were identified (g.15812T>G and g.15966A>G) in both nonsyndromic CL±P and noncleft patients. However, the association was not significant (P > .05). Three variants (g.19779C>T, g.19547G>A, and g.19712C>T) were identified in the Jagged2 gene among nonsyndromic CL±P and noncleft patients. Only g.19712C>T showed a significant association with nonsyndromic CL±P patients (P = .039). Conclusion g.19712C>T might play a crucial role in the development of cleft lip and palate. To the best of our knowledge, this is the first report of the mutation found within intron 13 of the Jagged2 gene among nonsyndromic CL±P Malay patients.

Safety comparison of over the counter bleaching with professionally prescribed home bleaching agent

Aims: This aimed to compare the colour changes, microhardness, and surface roughness of the human natural tooth after bleaching treatment with a professional home bleaching agent and over-the-counter (OTC) bleaching agent. Settings and Design: This was an in vitro study using extracted human teeth stained with human blood as specimens. Materials and Methods: Fifty-seven human natural teeth were embedded in acrylic of 2.5 mm thickness and 14 mm × 8 mm surface area. The samples were stained with human blood before they were divided into three groups (n = 19 per group) of control (C), Professional Bleaching Opalescence PF 15% (PB), and OTC Whitelight Tooth Whitening set (WL) before being treated with the respective bleaching agents for 10 days. Color changes were measured as colorimetric measurements (L*, a*, and b* values) were recorded during prestaining, poststaining, and postbleaching, while microhardness and surface roughness measurements were recorded for pre- and postbleaching. Statistical Analysis: Statistical analysis was done with SPSS (IBM Statistic, California, USA) version 22.0. Paired t-test and nonparametric analysis (Wilcoxon Signed-Rank Test) were used to analyze the data. P value was set as significant at P < 0.05. Results: The color changes in PB group was not significantly better compared with WL group (PB: 12.2 [4.07] and WL: 12.2 [4.32]). Whereas significant difference was noticed in microhardness after bleaching in PB group with a higher VHN number (500.4 [121.10]) compared with WL group (471.0 [114.47]) . The surface roughness (Ra) remain the same for all experimental groups. Conclusions: Both professional home bleaching agent and OTC bleaching agents showed similar efficacy, with no effect on surface roughness, and both caused an increase in microhardness.

Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

Objective Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed. Results A total of 190 patients were enrolled in the study, of whom 83 (43.7%) had FI only, and 107 (56.3%) had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US

A Preliminary Study on the Reliability of the Malay Version of the Quality of Life Inventory ⢠Version 4.0 (PEDSQL) Generic Core Scales among Children with Disabilities in Kelantan, Malaysia: Parent-Proxy Report

1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US

Oral health status of patients with psychiatric problem

1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia.