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Objective: The aim of this study was to evaluate the effects of suprabullar pneumatization on the orientation of the frontal sinus outflow structures and its association with the volume of anterior ethmoid sinus. Methods: A retrospective chart review of computed tomography of paranasal sinuses (CTPNS) images was conducted. A total of 370 sides of the CTPNS of 185 patients were analyzed. Results: The course of anterior ethmoidal artery (AEA) along the skull base (p = 0.04) and position of AEA at the second lamella (p = 0.04) was significantly associated with the type of suprabullar pneumatization. The AEA is expected to be lower at the skull base and at a longer distance from the second lamella with the increase in grading of the suprabullar pneumatization. The distance of AEA to the second lamella (p < 0.001) and third lamella (p = 0.04) was significantly different depending on the type of suprabullar pneumatization, which indicates AEA is expected to be at a longer distance from the second lamella and third lamella in higher grade suprabullar pneumatization. The type of suprabullar pneumatization has a significant but weak association with the anterior ethmoid sinus volume (p = 0.04). Conclusions: There is a significant effect of the type of suprabullar pneumatization on the orientation of the surrounding anatomical structures at the frontal recess. The type of suprabullar pneumatization is influenced by the anterior ethmoid sinus volume, which suggests it has a possible role in the frontal drainage pathway. [ABSTRACT FROM AUTHOR]

The main objective of this paper was to determine the utility of various anthropometric measures to assess total and regional body fatness using dual-energy X-ray absorptiometry (DXA) as the criterion in 454 adolescent boys and girls aged 12-19 years. Multivariable regression analyses of gender-specific and gender-combined models were used to determine anthropometric measures on DXA-derived body fatness models, after adjusting for known confounding biological factors. Partial correlation analyses, after adjusting for age, pubertal growth status and ethnicity in boys and girls, showed that body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-height ratio (WhtR) were significantly correlated with total body fat (TBF), percent body fat (%BF), android region fat (ARF) and trunk fat (TF) (all p<0.0001). BMI was the greatest independent determinant, contributing 43.8%-80.9% of the total variance for DXA-derived body fatness models. Results confirmed that a simple anthropometric index such as the BMI is a good surrogate indicator of body fat levels in Malay and Chinese adolescents. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Bilateral renal arteriovenous malformation are rare. Embolization is the currently preferred choice of intervention with high successful rate and significant reduction of morbidity. This case illustrate successful treatment of renal arteriovenous malformation with percutaneous embolization in our centre. CASE REPORT: 45 years old Malay lady with back ache and persistent hematuria of one year duration. No history of hypertension or cardiac failure. Presence of red blood cells in urine, other blood investigations are normal. Screening for connective tissue disease are negative. Ultrasound shows prominent vessels of right pelvicalyceal system. CT scan shown multiple rounded enhancing tubular structure similar to vessels in both kidneys with early enhancement of renal veins (during arterial phase). Angiogram revealed bilateral renal arteriovenous malformation. Embolization was performed and total occlusion of the arteriovenous malformation achieved. CONCLUSION: Arteriovenous malformation of the kidneys are rare. Its estimated prevalence is less than 0.04%. Bell (1938) reviewed 30,000 consecutive autopsies and no renal arteriovenous malformation found. Bilateral involvement is even rarer. A review of 49 cases of renal AVM reveals that most are found in women and in the right kidney. Clinical presentation depends on angiographic appearance of the aneurysm. The cirsoid type is characterized by a high incidence of gross hematuria on presentation and the aneurysmal type is characterized by frequent occurrence of cardiovascular signs and symptoms. Colour duplex ultrasound shows the vascular nature of cystic mass within the kidneys. In CT scan, hallmark of these anomalies is visualization of IVC within arteriogram phase. Angiogram allows visualization numerous small supplying vessels with fistulous channels and provide access for simultaneous treatment. The goal of treatment is maximal preservation of functioning renal parenchyma and eradication of symptoms and hemodynamic effect associated with the abnormality. In the past, partial or total nephrectomy with arterial reconstructive procedures have been the most common method of treating symptomatic arteriovenous malformation. Embolization is currently the preferred intervention and shown promising result with significant reduction of morbidity compared to surgery. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Vertebral osteomyelitis is uncommon and involvement of C1 and C2 is even rarer. This case illustrate the difficulty in diagnosing this condition due to its rarity and vague initial signs and symptoms. CASE REPORT: 72 years old Malay lady with medical history of hypertension and chronic left otitis externa. She presented with sudden episode of left hemiplegia. On examination GCS 15/15, Blood pressure is 142/74 mmHg. Muscle power is 0/5(right upper limb) and 1/5(right lower limb). Blood investigations shows patient was slightly anemic with normal TWBC. Initial diagnosis of CVA was made. Later, she complaint of fever, unable to turn her head and dysphagia. Cervical radiograph shows subluxation of C1-C2 with osteoporotic changes. CT scan reveals destruction of C1 and C2. MRI shows infective spondylitis with anterior subligamentous, prevertebral and retropharyngeal collection HPE shows mixed acute and chronic inflammatory cells infiltrate. Stain for AFB is negative. C&S from this specimen shown actinobacter species with no evidence of TB. C1-C2 decompression via intra oral approach was done. Patient succumb to death due to sepsis 2 months later in ICU. CONCLUSION: Vertebral osteomyelitis is uncommon, with an incidence of 1 case per 100,000-250,000 population per year. Involvement of cervical vertebrae is even rarer. Most cases are due to haematogenous spread of pyogenic micro-organisms from a distant infective source. Because of its rarity and vague initial signs and symptoms, diagnosis is often delayed. Back or neck pain is the most common symptom and neurologic signs are not present until late in the disease course. Only about half of patients are febrile. Leukocytosis, is often absent or minimal in patients with chronic pyogenic vertebral osteomyelitis. Plain radiograph only shows findings after 2-4 weeks. CT findings include hypodensity at the infected disks, lytic fragmentation of the involved bone, gas within an involved vertebra, and decreased density of adjacent vertebrae and nearby soft tissues. MRI is complementary to CT scan. Radionuclide scan is more sensitive and become positive long before plain film changes are evident. [ABSTRACT FROM AUTHOR]

Mullerian duct anomalies are congenital abnormalities involving the female genital systems. A double uterus or uterine didelphys is one of the uterine duplication anomalies that result from impaired fusion with regard to the Mullerian ducts. The uterine didelphys can be diagnosed earlier in symptomatic patients. However, the diagnosis can be delayed or the patients may remain undiagnosed throughout their lifetime if asymptomatic. Pregnant women with uterine didelphys are at a greater risk for spontaneous miscarriage, malposition, premature labor, and cervical incompetence. Uterine didelphys are also associated with renal anomalies such as renal agenesis or duplex kidneys. We present a case of a 24-year-old primigravida who had a spontaneous pregnancy and underwent a lower segment cesarean section (LSCS) after a failed external cephalic version for the breech fetal position. The uterine didelphys was diagnosed postnatally. Her condition was associated with right renal agenesis and concomitant left renal calculus., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Che Musa et al.)

Aim: To determine the influence of physical activity (PA) and sedentary behavior (SB) on obesity profiles of 454 Malaysian adolescents aged 12 to 19., Methods: Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA)., Results: Gender-specific multivariate analyses showed boys with high levels of total PA and moderate-to-vigorous physical activity (MVPA) exhibited significantly lower levels of total body fat, percent body fat and android fat mass compared with low PA and MVPA groups, after adjusting for potential confounders. Girls with high SB levels showed significantly higher BMI, waist circumference and DXA-derived body fat indices than those at lower SB level. Multiple logistic analyses indicated that boys with low levels of total PA and MVPA had significantly greater obesity risk, 3.0 (OR 3.0; 95% CI, 1.1-8.1; p < 0.05) and 3.8-fold (OR 3.8; 95% CI, 1.4-10.1; p < 0.01), respectively, than more active boys. Only in girls with high SB level was there a significantly increased risk of obesity, 2.9 times higher than girls at low SP levels (OR 2.8; 95% CI, 1.0-7.5; p < 0.05).  , Conclusions: The present findings indicate that higher PA duration and intensity reduced body fat and obesity risk while high screen-based sedentary behaviors significantly adversely influenced body fat mass, particularly amongst girls when the PA level was low.