Search

This study investigated the sociodemographic profiles of patients attending public and private dental clinics and the types of treatment received. Patients (n=454) were interviewed using a structured questionnaire at two public and four private clinics in Sibu District, Sarawak. Generally, Chinese (74.7 %), females (60.0%) and urban dwellers (83.7 %) were more likely to visit the dentist. Both clinics had more females and more Chinese but private clinics had a lower percentage of female attendees (53.1 % versus 67.0 %) but a higher percentage of Chinese (85.0 % versus 64.5 %). Private attendees were younger (mean age of 31.0 years compared to 41.0 years) and from higher income households (median value of MR 2,000 versus MR 900) than public attendees. Treatments were mostly curative and a third of the visits were associated with painful conditions. Age ( p=0.006), gender ( p=0.003), ethnicity ( p

A house to house random survey on elderly subjects was undertaken in the District of Klang in Malaysia. The objective of this study was to investigate the prevalence of oral mucosal lesions (OML) among the elderly in this area. The primary units in the sampling frame were the Enumeration Blocks (EBs) as defined under the population census. All households of the selected EBs were considered as sampling units and members aged 60 and above were considered as respondents. There was a slight preponderance of females, with the Malays comprising the majority of the subjects. Of the 486 respondents, mean aged 69.1 +/- 7.3 yr, 111 had at least one oral mucosal lesion, a prevalence of 22.8%. A total of 145 lesions were detected. The prevalence of OML was highest among Indians and least among the Chinese. The most common finding was tongue lesions, recording a prevalence of 10.7%, followed by oral pigmentation (4.9%) and white lesions (4.3%). Denture related lesions were comparatively low at 2.5%. Two cases of oral cancer if representative would give a relatively high prevalence of 0.4%.

To assess the cross-sectional construct validity of the Malay-translated and cross-culturally adapted FACT-HN (v 4.0) for discriminative use in a sample of Malaysian oral cancer patients. A cross-sectional study of adults newly diagnosed with oral cancer. HRQOL data were collected using the FACT-HN (v 4.0), a global question and a supplementary set of eight questions ('MAQ') obtained earlier in pilot work. Of the 76 participants (61.8% female; 23.7% younger than 50), most (96.1%) had oral squamous cell carcinoma; two-thirds were in Stages III or IV. At baseline, patients' mean FACT summary (FACT-G, FACT-HN, FACT-HN TOI, and FHNSI) and subscale (pwb, swb, ewb, fwb, and hnsc) scores were towards the higher end of the range. Equal proportions (36.8%) rated their overall HRQOL as 'good' or 'average'; fewer than one-quarter rated it as 'poor', and only two as 'very good'. All six FACT summary and most subscales had moderate-to-good internal consistency. For all summary scales, those with 'very poor/poor' self-rated HRQOL differed significantly from the 'good/very good' group. All FACT summary scales correlated strongly (r0.75). Summary scales showed convergent validity (r0.90) but little discriminant validity. The discriminant validity of the FHNSI improved with the addition of the MAQ. The FACT-HN summary scales and most subscales demonstrated acceptable cross-sectional construct validity, reliability and discriminative ability, and thus appear appropriate for further use among Malaysian oral cancer patients.

The Oral Health Division, Ministry of Health in Malaysia piloted clinical pathways (cpath) in primary care in early 2003. This study investigated the knowledge, perception of cpaths and barriers faced by the clinicians involved in the pilot project. Self-administered questionnaires were sent to the clinicians (n=191). Dentists (67.9%) and dental nurses (70.6%) had good overall knowledge of cpaths. The majority of the clinicians (67.9% to 95.6%) perceived cpath positively in all areas. Only 9.2% of dentists encountered difficulties in using cpath forms compared to 28.4% of dental nurses. A higher proportion of dental nurses (73.5%) compared to dentists (64.8%) were willing to continue using cpath. The majority of dentists (76.7%) and dental nurses (73.1%) were willing to participate in future development of cpaths. Overall, there was evidence of managerial support for the pilot project. A follow-up of the pilot project was somewhat lacking as less than half (43.3%) of the clinicians reported that the state coordinator obtained feedback from them. The findings auger well for the future implementation of cpath should the Oral Health Division decide to adopt cpath routinely in the public oral health care service.

Altered expression of xenobiotic enzymes such as CYP1A1,GSTM1 and GSTT1 has been reported in some malignant tumors including oral cancer. However, the correlation between these enzymes and clinicopathologic parameters has not been well documented. The aim of this study was to investigate the associations between CYP1A1, GSTM1 and GSTT1 polymorphisms with patients? status at 2-year, age of onset, nodal status, tumor size and disease stage. A total of 195 oral cancer patients were included in this study. Peripheral blood was obtained from consented individuals and CYP1A1, GSTM1 and GSTT1 genotypes were determined using PCR and restriction enzyme digestion. Chi-square test and simple logistic regression yielding odds ratio (OR) was employed for comparison of all parameters except for age of onset where t-test was used. Patients with GSTM1/GSTT1 polymorphism were associated with almost triple increased risk of mortality at 2-year after the first being diagnosed (OR 2.79, 95% CI 1.22?6.36). Mean age of onset was higher in those with GSTT1 null (60.82 ± 10.61 years) and GSTM1/GSTT1 polymorphism genotype (59.48 ± 11.30 years) compared to lower mean age of onset for those with GSTT1 non-null (58.15 ± 11.97 years) and GSTM1/GSTT1 wild-type genotype and these observations were not significant. There was also no significant difference between CYP1A1 and GSTM1 polymorphisms and age of onset. Positive nodes are associated with high CYP1A1 polymorphism, GSTM1 null and GSTM1/GSTT1 polymorphism (59.7%, 56.5% and 72.6%, respectively) and low GSTT1 null (29.0%). For tumor size of more than 2 cm, there was higher percentage of GSTT1 null genotype (92.7%) as compared to those with tumor size of less than 2 cm (p = 0.035). Polymorphisms of all three genes were higher in late stage compared to early stage disease. However, statistically, these observations were not significant. In conclusion, no association was observed between CYP1A1 and GSTM1 polymorphisms and all clinicopathologic parameters studied. This study also showed that for GSTM1/GSTT1 and GSTT1 polymorphisms, association was seen with patients? status at 2-year and tumor size respectively, indicating that the GST genotypes may be important indicators for the patients? status and tumor size in oral cancer.

Introduction: Uncoordinated data collection by different research groups prompted the initiation of Malaysian oral cancer Research Initiative (MOCRI) group. Objectives: To coordinate and standardize data and tissue collection and storage, develop a minimum dataset on risk factors, intervention techniques and quality of life of oral cancer patients. Materials and Methods: A computer software programme is currently being developed to accommodate multi-centre data collection and research activities in eight hospitals. The complete dataset includes parameters on sociodemographic, clinical, pathological, quality of life measures, details of treatment methods, vital status and dietary intake. Tissues are being collected, stored and catalogued as fresh and formalin-fixed tissues for future use in satellite researches. The networking in tissue and data collection includes the establishment of oral cancer cell-lines. These tissues are being planned for studies on genetic profile, genetic polymorphism, diagnostic and prognostic markers. Results: Tissues and data on 115 oral cancers, 9 leukoplakia and 13 lichen planus has been collected since 2003. Preliminary data from 2004 were analysed for 58 cancer patients. Majority of them are more than 60 years old (65.5%) with a mean age of 63.3. Twenty-four (41.4%) were males, 34 (58.6%) females with the majority of them being Indians (56.9%) followed by Chinese and Malays (15.5% each), Indigenous people of Sabah and Sarawak (12.1%). Eighteen (31%) respondents were smokers, 17 (29.3%) alcohol drinkers and 31 (53.4%) betel quid chewers. Five patients have had histories of family cancers where 3 included immediate family members with head and neck cancers. For the quality of life measure, only 30.2% felt that their daily activities were disrupted despite having advanced cancers. Satellite researches are in progress on genetic polymorphism and tumour markers. One oral cancer cell-line has been established. Conclusion: The establishment of oral cancer database and tissue bank in encouraging and supports on-going satellite researches.