Sex estimation in the South-East Asian population: A systematic review.

INTRODUCTION: Sex estimation is crucial in forensic anthropology. In situations such as mass disasters, and forensic anthropology cases, sex estimation is a very important initial step in the disaster victim identification process. Literature has acknowledged that sex estimation is population-specific. However, sex estimation standards in South-East Asian populations are limited, leading to the usage of most Thais discriminant function equations on sex estimation by other South-East Asian countries including Malaysia. This systematic review was conducted to summarise the findings of sex estimation studies in South-East Asian countries. MATERIALS AND METHODS: A systematic literature search was performed through the SCOPUS database and Web of Science (WOS) database for relevant studies between 2014 and 2022. All published articles that are related to sex estimation from different types of bone, methods, landmarks, and sample sources (i.e., photographs, dry bones, and CT images) were included in this review. The main inclusion criteria were studies on (i) sex estimation; (ii) in South-East Asian populations; (iii) between the years 2014 and 2022; and (iv) in English. RESULTS: The literature search identified 30 potentially relevant studies, of which 15 publications met all the inclusion criteria. From those research, 13 studies were related to the Thai population and two to the Malaysian population. Only one study was based on morphological traits, while the rest were based on a morphometric approach. CONCLUSION: All studies found that sex estimation is populationspecific. Therefore, further research is recommended to explore more on population-specific sex estimation using different parts of bone.

A Pragmatic Approach to the Management of Severe Awake Bruxism in an Adolescent with Cerebral Palsy and Global Developmental Delay.

Cerebral palsy is a neurological and motor condition characterised by muscle balance and posture impairments. Bruxism and malocclusion were frequently observed in patients with cerebral palsy, in contrast to other oral anomalies. The report outlines how severe awake bruxism is managed in a 16-year-old Korean boy who has nonverbal spastic cerebral palsy and global developmental delay. The treatment protocol involved the fabrication of soft occlusal splints of three and four millimetres in thickness, followed by the placement of stainless-steel crowns on all first permanent molars whilst video recording and a bruxism diary was kept. Fixed restorations demonstrate increased endurance in withstanding bruxism force in persons who are dependent on their caretaker.

Antenatal care parameters that are the risk factors in the event of preeclampsia in primigravida.

OBJECTIVE: This study aimed to analyze the parameters of antenatal care, which becomes a risk factor against the incidence of preeclampsia in primigravidae in Kolaka. METHODS: The study uses case-control studies (case-control), which use a retrospective approach. The population in this study were all primigravida pregnant women recorded in the medical records at the BLUD Hospital. HM Djafar Harun as many as 5796 women and BLUD Benyamin Guluh Hospital as many as 5065 women. The sample in this case group is the primary mother Gravida, who suffered from preeclampsia from January 2014 to September 2018, and the control group was primigravida mothers who did not suffer from preeclampsia in the same period. RESULTS: The results showed that the age of primigravida mothers 14-28 years had a risk of 1.581 times more significant for having preeclampsia than the age group 29-49 years with CI (1.186-2.108), the incidence of hypertension in trimester 1 in primigravida mothers had a risk of 3.405 times greater for preeclampsia than mothers without a history of hypertension in trimester 1 with CI (2.164-5.358), irregular antenatal visits are 1.095 times more likely to develop preeclampsia than regular antenatal visits with CI (0.799-1.539), weight gain primigravida maternal body 1-10kg 1.540 times greater risk of developing preeclampsia than 10-20kg of weight gain with CI (1.074-2.207), pregnancy checks according to Antenatal Care non-compliant care standards are 1.333 times more likely to develop preeclampsia than primigravida mothers who obediently do the inspection antenatal care with CI (0.970-1.831). CONCLUSION: Variables that are very risky with preeclampsia in primigravida mothers based on multivariate analysis are the hypertension incidence in the first trimester with an OR: 3.363 with a CI value of 2.126 and a lower value of 5.318.

Tiger nut (Cyperus esculentus) as a potential phytoinsecticide: larvicidal activity of crude extracts on Aedes aegypti and Culex quinquefasciatus (Diptera: Culicidae).

Plants contain bioactive compounds and are constantly explored as safer alternatives to conventional insecticides. Despite numerous studies on many plants, information on the insecticidal potential of underutilised plants like tiger nut, Cyperus esculentus L., are scant, although their pharmacological potentials are well known. Hence, this study investigated the larvicidal potential of crude aqueous extracts of two C. esculentus varieties (black and yellow) on the mosquitoes Aedes aegypti (L.) and Culex quinquefasciatus (Say). Mosquito larvae were exposed to C. esculentus crude extracts using the larval bioassay technique of the World Health Organization. Differential larvicidal responses were observed in the test mosquitoes and extracts of Black Dried Tiger nuts (BDT) were more larvicidal than Yellow Dried Tiger nuts (YDT). Acute larval toxicity of the extracts was more pronounced on Cx. quinquefasciatus than Ae. aegypti. The results indicate the potential of C. esculentus (particularly BDT) as a source of mosquito bioinsecticide and merits further studies as a safer alternative to conventional insecticide-based vector control.

Physicochemical characteristics of liposome encapsulation of stingless bees' propolis.

Nutraceuticals from natural sources have shown potential new leads in functional food products. Despite a broad range of health-promoting effects, these compounds are easily oxidized and unstable, making their utilization as nutraceutical ingredients limited. In this study, the encapsulated stingless bees' propolis in liposome was prepared using soy phosphatidylcholine and cholesterol by thin-film hydration technique. Three different formulations of phosphatidylcholine composition and cholesterol prepared by weight ratio was conducted to extract high propolis encapsulation. Physicochemical changes in the result of the encapsulation process are briefly discussed using scanning electron microscopy and Fourier Transform Infrared Spectroscopy. A dynamic light-scattering instrument was used to measure the hydrodynamic diameter, polydispersity index, and zeta potential. The increment of the liposomal size was observed when the concentration of extract loaded increased. In comparing three formulations, F2 (8:1 w/w) presented the best formulation as it yielded small nanoparticles of 275.9 nm with high encapsulation efficiency (66.9%). F1 (6:1 w/w) formed large particles of liposomes with 422.8 nm, while F3 (10:1 w/w) showed low encapsulation efficiency with (by) 38.7%. The liposome encapsulation will provide an effective nanocarrier system to protect and deliver the flavonoids extracted from stingless bees' propolis.

Distribution of virulence genes and the molecular epidemiology of Streptococcus pyogenes clinical isolates by emm and multilocus sequence typing methods.

BACKGROUND: Streptococcus pyogenes has a variety of virulence factors and the predominant invasive strains differ according to specific emm types and geographical orientation. Although emm typing is commonly used as the gold standard method for the molecular characterisation, multilocus sequence typing (MLST) has become an important tool for comparing the genetic profiles globally. This study aimed to screen selected virulence genes from invasive and non-invasive clinical samples and to characterise the molecular epidemiology by emm typing and MLST methods. MATERIALS AND METHODS: A total of 42 S. pyogenes isolates from invasive and non-invasive samples collected from two different tertiary hospitals were investigated for the distribution of virulence factors and their molecular epidemiology by emm and multilocus sequence typing methods. Detection of five virulence genes (speA, speB, speJ, ssa and sdaB) was performed using multiplex polymerase chain reaction (PCR) using the standard primers and established protocol. Phylogenetic tree branches were constructed from sequence analysis utilised by neighbour joining method generated from seven housekeeping genes using MEGA X software. RESULTS: Multiplex PCR analysis revealed that sdaB/speF (78.6%) and speB (61.9%) were the predominant virulence genes. Regardless of the type of invasiveness, diverse distribution of emm types/subtypes was noted which comprised of 27 different emm types/subtypes. The predominant emm types/subtypes were emm63 and emm18 with each gene accounted for 11.8% whereas 12% for each gene was noted for emm28, emm97.4 and emm91. The MLST revealed that the main sequence type (ST) in invasive samples was ST402 (17.7%) while ST473 and ST318 (12% for each ST) were the major types in non-invasive samples. Out of 18 virulotypes, Virulotype A (five genes, 55.6%) and Virulotype B (two genes, 27.8%) were the major virulotypes found in this study. Phylogenetic analysis indicated the presence of seven different clusters of S. pyogenes. Interestingly, Cluster VI showed that selected emm/ST types such as emm71/ST318 (n=2), emm70.1/ST318 (n=1), emm44/ST31 (n=1) and emm18/ST442 (n=1) have clustered within a common group (Virulotype A) for both hospitals studied. CONCLUSION: The present study showed that group A streptococcci (GAS) are genetically diverse and possess virulence genes regardless of their invasiveness. Majority of the GAS exhibited no restricted pattern of virulotypes except for a few distinct clusters. Therefore, it can be concluded that virulotyping is partially useful for characterising a heterogeneous population of GAS in hospitals.

Tiger nut (Cyperus esculentus) as a potential phytoinsecticide: larvicidal activity of crude extracts on Aedes aegypti and Culex quinquefasciatus (Diptera: Culicidae)

@#Plants contain bioactive compounds and are constantly explored as safer alternatives to conventional insecticides. Despite numerous studies on many plants, information on the insecticidal potential of underutilised plants like tiger nut, Cyperus esculentus L., are scant, although their pharmacological potentials are well known. Hence, this study investigated the larvicidal potential of crude aqueous extracts of two C. esculentus varieties (black and yellow) on the mosquitoes Aedes aegypti (L.) and Culex quinquefasciatus (Say). Mosquito larvae were exposed to C. esculentus crude extracts using the larval bioassay technique of the World Health Organization. Differential larvicidal responses were observed in the test mosquitoes and extracts of Black Dried Tiger nuts (BDT) were more larvicidal than Yellow Dried Tiger nuts (YDT). Acute larval toxicity of the extracts was more pronounced on Cx. quinquefasciatus than Ae. aegypti. The results indicate the potential of C. esculentus (particularly BDT) as a source of mosquito bioinsecticide and merits further studies as a safer alternative to conventional insecticide-based vector control.

Antenatal care parameters that are the risk factors in the event of preeclampsia in primigravida

Objective: This study aimed to analyze the parameters of antenatal care, which becomes a risk factor against the incidence of preeclampsia in primigravidae in Kolaka. Methods: The study uses case–control studies (case–control), which use a retrospective approach. The population in this study were all primigravida pregnant women recorded in the medical records at the BLUD Hospital. HM Djafar Harun as many as 5796 women and BLUD Benyamin Guluh Hospital as many as 5065 women. The sample in this case group is the primary mother Gravida, who suffered from preeclampsia from January 2014 to September 2018, and the control group was primigravida mothers who did not suffer from preeclampsia in the same period. Results: The results showed that the age of primigravida mothers 14–28 years had a risk of 1.581 times more significant for having preeclampsia than the age group 29–49 years with CI (1.186–2.108), the incidence of hypertension in trimester 1 in primigravida mothers had a risk of 3.405 times greater for preeclampsia than mothers without a history of hypertension in trimester 1 with CI (2.164–5.358), irregular antenatal visits are 1.095 times more likely to develop preeclampsia than regular antenatal visits with CI (0.799–1.539), weight gain primigravida maternal body 1–10 kg 1.540 times greater risk of developing preeclampsia than 10–20 kg of weight gain with CI (1.074–2.207), pregnancy checks according to Antenatal Care non-compliant care standards are 1.333 times more likely to develop preeclampsia than primigravida mothers who obediently do the inspection antenatal care with CI (0.970–1.831). Conclusion: Variables that are very risky with preeclampsia in primigravida mothers based on multivariate analysis are the hypertension incidence in the first trimester with an OR: 3.363 with a CI value of 2.126 and a lower value of 5.318. (AU)

Viability of dengue virus in culture stocks is efficiently preserved by storage in diluted forms.

Storage of dengue virus (DENV) culture stocks in -80°C is a common laboratory practice to maintain the viability of the virus for long-term usage. However, the efficiency of this method could still be hindered by multiple factors. In our laboratory, we observed a constant and substantial deterioration in the titer of DENV in Vero culture supernatant stored in -80°C. Such incident had badly hampered the laboratory work and prompted an investigation to determine the cause. DENV isolates representing all four serotypes were propagated and the culture supernatants were harvested and stored in aliquots of original stock and 10 fold dilutions (10-1 -10-4). DENV titer in these stocks was determined prior to storage and reassessed on the third and sixth month of storage by focus forming unit assay (FFUA). The result demonstrated a constant preservation of titer ranging from 104 ffu/ml to 105 ffu/ml in the diluted DENV virus culture stocks of 10-1, and 10-2 of DENV1-4, a minor reduction of titer from 103 ffu/ml to 102 ffu/ml at dilution 10-3 for DENV4 only and complete deterioration in undiluted culture stock and lower dilution (10-4) within 6 months of storage in -80°C for all serotypes. It is recommended that propagated DENV in Vero cells are stored in 10 fold dilutions as compared to the original form to preserve the titer for long-term usage.

Viability of dengue virus in culture stocks is efficiently preserved by storage in diluted forms

@#Storage of dengue virus (DENV) culture stocks in -80°C is a common laboratory practice to maintain the viability of the virus for long-term usage. However, the efficiency of this method could still be hindered by multiple factors. In our laboratory, we observed a constant and substantial deterioration in the titer of DENV in Vero culture supernatant stored in -80°C. Such incident had badly hampered the laboratory work and prompted an investigation to determine the cause. DENV isolates representing all four serotypes were propagated and the culture supernatants were harvested and stored in aliquots of original stock and 10 fold dilutions (10-1 -10-4). DENV titer in these stocks was determined prior to storage and reassessed on the third and sixth month of storage by focus forming unit assay (FFUA). The result demonstrated a constant preservation of titer ranging from 104 ffu/ml to 105 ffu/ml in the diluted DENV virus culture stocks of 10-1, and 10-2 of DENV1-4, a minor reduction of titer from 103 ffu/ml to 102 ffu/ml at dilution 10-3 for DENV4 only and complete deterioration in undiluted culture stock and lower dilution (10-4) within 6 months of storage in -80°C for all serotypes. It is recommended that propagated DENV in Vero cells are stored in 10 fold dilutions as compared to the original form to preserve the titer for long-term usage.

Automated monitoring of behaviour in zebrafish after invasive procedures.

Fish are used in a variety of experimental contexts often in high numbers. To maintain their welfare and ensure valid results during invasive procedures it is vital that we can detect subtle changes in behaviour that may allow us to intervene to provide pain-relief. Therefore, an automated method, the Fish Behaviour Index (FBI), was devised and used for testing the impact of laboratory procedures and efficacy of analgesic drugs in the model species, the zebrafish. Cameras with tracking software were used to visually track and quantify female zebrafish behaviour in real time after a number of laboratory procedures including fin clipping, PIT tagging, and nociceptor excitation via injection of acetic acid subcutaneously. The FBI was derived from activity and distance swum measured before and after these procedures compared with control and sham groups. Further, the efficacy of a range of drugs with analgesic properties to identify efficacy of these agents was explored. Lidocaine (5 mg/L), flunixin (8 mg/L) and morphine (48 mg/L) prevented the associated reduction in activity and distance swum after fin clipping. From an ethical perspective, the FBI represents a significant refinement in the use of zebrafish and could be adopted across a wide range of biological disciplines.

Antifungal susceptibilities, biofilms, phospholipase and proteinase activities in the Candida rugosa complex and Candida pararugosa isolated from tertiary teaching hospitals.

PURPOSE: Non-albicansCandida species have emerged as fungal pathogens that cause invasive infections, with many of these species displaying resistance to commonly used antifungal agents. This study was confined to studying the characteristics of clinical isolates of the C. rugosa complex and C. pararugosa species. METHODOLOGY: Seven isolates of the C. rugosa complex and one isolate of C. pararugosa were obtained from two tertiary referral hospitals in Malaysia. Their antifungal susceptibilities, biofilm, proteinase, phospholipase, esterase and haemolysin activities were characterized. Biofilms were quantified using crystal violet (CV) and tetrazolium (XTT) reduction assays at 1.5, 6, 18, 24, 48 and 72 h.Results/Key findings. The E-test antifungal tests showed that both species have elevated MICs compared to C. albicans and C. tropicalis. The highest biomass was observed in one of the C. rugosa isolates (0.237), followed by C. pararugosa (0.206) at 18 h of incubation. However, the highest bioactivity was observed in the C. rugosa ATCC 10571 strain at 24 h (0.075), followed by C. pararugosa at 48 h (0.048) and the same C. rugosa strain at 24 h (0.046), with P<0.05. All isolates exhibited high proteinase activity (+++) whereas six isolates showed very strong esterase activity (++++). All the isolates were alpha haemolytic producers. None of the isolates exhibited phospholipase activity. CONCLUSION: Elevated MICs were shown for the C. rugosa complex and C. pararugosa for commonly used antifungal drugs. Further studies to identify virulence genes involved in the pathogenesis and genes that confer reduced drug susceptibility in these species are proposed.

Purification, expression and partial characterization of glutathione s-transferases (GSTs) from three different strains of Aedes albopictus (Diptera: Culicidae).

Glutathione S-transferases (GSTs) are multifunctional enzymes involved in detoxification of xenobiotic compounds in many insect groups. This work investigated the expression of GSTs in Aedes albopictus by using affinity chromatography and proteomic analysis. The study compared the expression of GSTS isoforms in larvae of three Ae. albopictus strains (susceptible (VCRU) strain, field Kuala Lumpur (KL) strain and laboratory permethrintreated strain). The study demonstrated that the expression of sixteen isoforms (GSTS1-1, GSTS1-4, GSTS1-3, GSTS1-4, GSTD1-3, GSTD1-2, GSTD1-5, GSTD1-6, GSTD1-7, GSTD1-8, GSTD1-9, GSTD1-10, GSTD1-11, GSTT, GSTD1-12, and GSTD1-13) were significantly increased in the field KL strain (p<0.05) compared to the susceptible VCRU strain. GSTD1-1, GSTD1-2 and GSTS1-5 showed no significant difference in expression between the two strains (p>0.05). However, while comparing the expression of GST isoforms in field KL larvae and laboratory permethrin-treated strain, the same pattern was observed for all the GSTs especially for Theta and Sigma class (p>0.05). In Delta class, only GSTD1-1, GSTD1-9, GSTD1-11, GSTD1- 12 and GSTD1-13 shows significant difference in expression between these two strain (p<0.05). This comparative data on GST expression in Ae. albopictus can be useful database to identify possible underlying mechanisms governing insecticide resistance by GSTs.

Purification, expression and partial characterization of glutathione s-transferases (GSTs) from three different strains of Aedes albopictus (Diptera: Culicidae)

Glutathione S-transferases (GSTs) are multifunctional enzymes involved in detoxification of xenobiotic compounds in many insect groups. This work investigated the expression of GSTs in Aedes albopictus by using affinity chromatography and proteomic analysis. The study compared the expression of GSTS isoforms in larvae of three Ae. albopictus strains (susceptible (VCRU) strain, field Kuala Lumpur (KL) strain and laboratory permethrintreated strain). The study demonstrated that the expression of sixteen isoforms (GSTS1-1, GSTS1-4, GSTS1-3, GSTS1-4, GSTD1-3, GSTD1-2, GSTD1-5, GSTD1-6, GSTD1-7, GSTD1-8, GSTD1-9, GSTD1-10, GSTD1-11, GSTT, GSTD1-12, and GSTD1-13) were significantly increased in the field KL strain (p0.05). However, while comparing the expression of GST isoforms in field KL larvae and laboratory permethrin-treated strain, the same pattern was observed for all the GSTs especially for Theta and Sigma class (p>0.05). In Delta class, only GSTD1-1, GSTD1-9, GSTD1-11, GSTD1- 12 and GSTD1-13 shows significant difference in expression between these two strain (p<0.05). This comparative data on GST expression in Ae. albopictus can be useful database to identify possible underlying mechanisms governing insecticide resistance by GSTs.

Identification and in vitro antimicrobial susceptibility of Brucella species isolated from human brucellosis.

Brucellosis is a world-wide zoonotic disease with a major impact on the public health. Due to the high risk of laboratory acquired infection, limited laboratory investigations were performed on this organism, including detailed identification and susceptibility study. Brucella melitensis is the commonest aetiological agent for human brucellosis in this region. The in vitro susceptibility pattern against selected antimicrobial agents was assessed using E-test. All isolates were noted to be sensitive to all the antimicrobial agents tested except for rifampicin where elevated MIC > 1 µg/mL was noted in 30 out of 41 isolates tested.

Assessment of oxidant/antioxidant status in saliva of cell phone users.

Hazardous health effects resulting from exposure to radiofrequency electromagnetic radiation (RF-EMR) emitted from cell phones have been reported in the literature. However, the cellular and molecular targets of RF-EMR are still controversial. The aim of this study was to examine the oxidant/antioxidant status in saliva of cell phone users. Saliva samples collected before using a cell phone as well as at the end of 15 and 30 min calls were tested for two commonly used oxidative stress biomarkers: malondialdehyde (MDA) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-Oxo-dG). The 8-oxo-dG levels were determined by enzyme-linked immunosorbent (ELISA) competitive assay, while the MDA levels were measured using the OxiSelect MDA adduct ELISA Kit. The antioxidant capacity of the saliva was evaluated using the oxygen radical absorption capacity (ORAC) and the hydroxyl radical averting capacity (HORAC) assays according to the manufacture instructions. The mean 8-oxo-dG and the Bradford protein concentrations (ng/ml and mg/ml, respectively) peaked at 15 min. The levels of HORAC, ORAC and MDA progressively increased with time and reached maximum at 30 min. However, there was no significant effect of talking time on the levels of 8-OxodG and MDA. Similarly, there was no statistically significant effect of talking time on the oxygen and hydroxyl radicals averting capacities, (ORAC) and (HORAC), respectively. These findings suggest that there is no relationship between exposure to radio frequency radiation (RFR) and changes in the salivary oxidant/antioxidant profile.

Assessment of natural radioactivity levels in rocks and their relationships with the geological structure of Johor state, Malaysia.

The distribution of natural radionuclides ((238)U, (232)Th and (40)K) and their radiological hazard effect in rocks collected from the state of Johor, Malaysia were determined by gamma spectroscopy using a high-purity germanium detector. The highest values of (238)U, (232)Th and (40)K activity concentrations (67±6, 85±7 and 722±18 Bg kg(-1), respectively) were observed in the granite rock. The lowest concentrations of (238)U and (232)Th (2±0.1 Bq kg(-1) for (238)U and 2±0.1 Bq kg(-1) for (232)Th) were observed in gabbro rock. The lowest concentration of (40)K (45±2 Bq kg(-1)) was detected in sandstone. The radium equivalent activity concentrations for all rock samples investigated were lower than the internationally accepted value of 370 Bq kg(-1). The highest value of radium equivalent in the present study (239±17 Bq kg(-1)) was recorded in the area of granite belonging to an acid intrusive rock geological structure. The absorbed dose rate was found to range from 4 to 112 nGy h(-1). The effective dose ranged from 5 to 138 µSv h(-1). The internal and external hazard index values were given in results lower than unity. The purpose of this study is to provide information related to radioactivity background levels and the effects of radiation on residents in the study area under investigation. Moreover, the relationships between the radioactivity levels in the rocks within the geological structure of the studied area are discussed.

Dental fear and anxiety in children and adolescents: qualitative study using YouTube.

BACKGROUND: Dental fear and anxiety (DFA) refers to the fear of and anxiety towards going to the dentist. It exists in a considerable proportion of children and adolescents and is a major dilemma in pediatric dental practice. As an Internet social medium with increasing popularity, the video-sharing website YouTube offers a useful data source for understanding health behaviors and perceptions of the public. OBJECTIVE: Using YouTube as a platform, this qualitative study aimed to examine the manifestations, impacts, and origins of DFA in children and adolescents from the public's perspective. METHODS: To retrieve relevant information, we searched YouTube using the keywords "dental fear", "dental anxiety", and "dental phobia". Videos in English expressing a layperson's views or experience on children's or adolescent's DFA were selected for this study. A video was excluded if it had poor audiovisual quality, was irrelevant, was pure advertisement or entertainment, or contained only the views of professionals. After the screen, we transcribed 27 videos involving 32 children and adolescents, which were reviewed by a panel of 3 investigators, including a layperson with no formal dental training. Inductive thematic analysis was applied for coding and interpreting the data. RESULTS: The videos revealed multiple manifestations and impacts of DFA, including immediate physical reactions (eg, crying, screaming, and shivering), psychological responses (eg, worry, upset, panic, helplessness, insecurity, resentment, and hatred), and uncooperativeness in dental treatment. Testimonials from children, adolescents, and their parents suggested diverse origins of DFA, namely personal experience (eg, irregular dental visits and influence of parents or peers), dentists and dental auxiliaries (eg, bad manner, lack of clinical skills, and improper work ethic), dental settings (eg, dental chair and sounds), and dental procedures (eg, injections, pain, discomfort, and aesthetic concerns). CONCLUSIONS: This qualitative study suggests that DFA in children and adolescents has multifaceted manifestations, impacts, and origins, some of which only became apparent when using Internet social media. Our findings support the value of infodemiological studies using Internet social media to gain a better understanding of health issues.

The Community Follow-up Project (CFUP).

The Community Follow-up Project (CFUP) is a project where medical students choose a hospital in-ward patient during their clinical ward-based attachments and follow-up this patient's progress after discharge from the hospital. The students do a series of home visits and also accompany their patients for some of their follow-ups at the hospital, government clinics, general practitioners' clinics and even to the palliative care or social welfare centres. The students assess the physical, psychological and social impact of the illness on the patient, family and community. By following their patients from the time their patients were in the hospital and back to their homes and community, the students are able to understand in depth the problems faced by patients, the importance of communication skills in educating patients on their illness and the importance of good communication between primary, secondary and tertiary care.

Prevalence of cleft lip and palate in a hospital-based population in the Sudan.

UNLABELLED: Cleft lip and palate represents one of the most common developmental deformities seen in oral surgery clinics. It is usually associated with problems which include not only cosmetic and dental abnormalities, but also speech, hearing and facial growth difficulties. OBJECTIVES: The purpose of the present study was to determine the prevalence of cleft lip and palate in births taking place in hospitals in the Sudan. METHODS: The records of 15,890 Sudanese new-borns delivered at three hospitals during the period from 1997 to 2000 were examined. RESULTS: Thirteen cases of cleft lip and palate were found, demonstrating a prevalence of 0.9 per 1000. There were more girls than boys, with a male:female ratio of 3:10. Fifty-four per cent of the cases had cleft lip with cleft palate, 30% had only cleft palate and the remaining 16% had cleft lip alone. CONCLUSIONS: The present study was confined to hospital-based births in one city, and the true incidence of cleft lip and/or palate in the Sudan is not yet known. Findings differ from reports from other countries in terms of suggesting a higher incidence in girls.