Borneo Journal of Medical Sciences (BJMS)

Anterior Aesthetic Rehabilitation with Injection Moulding Technique: A Case Series

Mohd Khairul Firdaus Mazlan — 2026-01-05

The injection molding technique has gained popularity for its minimally invasive and time-efficient approach in direct anterior restorations. This case series highlights three clinical cases utilizing injectable resin composite for restoring aesthetics and function in amelogenesis imperfecta and irregularly shaped teeth post-orthodontic treatment. The technique, employing light-cured injectable composite, polymerized through transparent silicone index. The approach ensures optimal composite placement, accurate replication of tooth morphology, minimizes the air entrapment and enhances both the durability and aesthetics of the restoration with a strong marginal seal. The clinical time for the restoration has been considerably reduced thus enhances the patient experience. These cases demonstrate that the injection molding technique is a versatile, provides superior aesthetics, and offers predictable results for anterior direct restorations.

Dental Aesthetics and Functional Rehabilitation in a Case of Reinfection and Tooth Loss: A case report

Mohd Khairul Firdaus Mazlan — 2026-01-05

In this clinical report, a 41-year-old Malay female patient presented with reinfection of her root treated central incisor teeth. There was a significant loss of coronal tooth structure in the maxillary anterior teeth and missing posterior teeth requiring a restorative solution. A combination of conventional prosthodontic techniques and a digital workflow was employed for optimal outcomes. To address the loss of coronal tooth structure, indirect all-ceramic restorations with post core were chosen. These restorations offer excellent aesthetics and durability, closely resembling natural teeth. The utilization of digital technology ensured precise measurements and fabrication, resulting in restorations that fit accurately and function optimally. For the bilateral missing teeth in the first molar region that has impacted the patient's ability to chew effectively, implant-supported crowns were provided to restore the masticatory performance. Dental implants provided a stable foundation for the crowns, improving chewing efficiency and overall oral function. The treatment approach successfully restored both aesthetics and functionality, significantly enhancing the patient's quality of life. Regular follow-up visits and maintenance protocols were implemented to ensure long-term success.

Double Incontinence as Adverse Effect During Brief Usage of Clonazepam

Al Hafiz Ibrahim — 2026-01-05

Clonazepam, a benzodiazepine used for treating seizures, anxiety disorders, and movement disorders, is known for its central nervous system depressant side effects, such as drowsiness and urinary incontinence. However, double incontinence is rarely reported. We present the case of a 41-year-old woman with multilevel degenerative disc disease and right gastrocnemius-soleus muscle spasticity secondary to an Achilles tendon rupture, who developed who experienced dual incontinence after brief clonazepam use. Within three days of commencing clonazepam, she experienced nausea, fatigue, drowsiness, loose stools, and urinary frequency, progressing to urinary and faecal incontinence. Investigations, including blood tests, urine analysis, and abdominal imaging, were unremarkable, ruling out differential diagnoses such as infections, spinal pathology, and metabolic disorders. The patient responded positively to the antidote and supportive medical care, with total symptom relief two days after cessation of the medication. We discussed the causes of double incontinence, potential drug-induced incontinence, and the possible mechanisms by which clonazepam could cause double incontinence, given the limited evidence on it. Clonazepam’s sedative effects can lead to decreased muscle tone and coordination, potentially resulting in incontinence. Additionally, its impact on GABAergic pathways and anticholinergic effects could influence bladder and bowel function indirectly, but this is just a theory, and actual evidence is difficult to find. underscores the need for clinicians to recognize double incontinence as a potential adverse effect of clonazepam, even with short-term use, and to consider dose adjustments or alternative therapies when indicated. Further research into the mechanisms of clonazepam-induced double incontinence is warranted given the limited existing evidence.

Lithium as Neglected Drinking Water Parameter and Effect on Foetal Growth: A Review

Muhammad Ridzwan Rafi'i — 2026-01-05

Lithium (Li) is a heavy metal that is very important currently due to its use in several industrial activities. Recently, Li has been regarded as an emerging environmental pollutant and has attracted many researchers globally due to its availability and high environmental concentration, especially in surface water. Several neonatal health impacts due to Li exposure from drinking water were extensively studied and reviewed previously, such as prematurity, miscarriages, and hypothyroidism. However, a dearth of reviews focuses on Li drinking water exposure to fetus growth impact. We searched articles published between January 1, 1990, and September 10, 2024, using three electronic databases (PubMed, Scopus, and Web of Science). A total of 24 articles were eliminated during the screening process. Ultimately, just one article (n = 1) was approved and featured in this review. In the particular study, they found a negative correlation between maternal blood Li levels (median 25; range 1.9–145 μg/L) and urine (1645; 105–4600 μg/L) and all fetus measurements (body, head, and femur) during the second trimester, as well as birth length. A rise of 100 μg/L in blood Li was generally linked to a 2 cm (about one standard deviation) reduction in birth length and fetus growth. Existing evidence indicates a negative association between Li exposure from drinking water and fetus growth. Additionally, long-term health implications for offspring exposed to Li in utero, mainly through drinking water, are under-researched, calling for more comprehensive studies that explore both immediate and chronic health outcomes.

Integrating the Protection Motivation Theory Scale Among Older Adults: Insights for Fall Prevention Behaviour

Mei Fong Ong — 2026-01-05

This commentary examines the application of the Protection Motivation Theory (PMT) scale to evaluate older adults’ threat and coping appraisals, fear, and protective behaviours in reducing fall risks. The findings highlighted the impact of fear, threat and coping appraisals on older adults’ intentions to adopt protection motivation to reduce fall risk. Mediating effects are found in coping appraisal for protective behaviour, fear for perceived cost, and threat appraisal for protection motivation. This study has also emphasised the implications of adopting the PMT scale among older adults in Sarawak, Malaysia.

Assessment of Spiritual Care Competency among Nurses in Sultan Ahmad Shah Medical Centre: A Cross-Sectional Study

Nor'ain Abdul Rashid — 2026-01-05

Spiritual care, which is considered a significant part in holistic nursing care, involves nurses to fulfill the patients with emotional, psychological, and spiritual needs. Spiritual care competency is an important aspect in maximizing the quality of care to the patients and encouraging professionalism. This study aimed to assess the level of spiritual care competency among nurses in SASMEC, and association between sociodemographic factors with the level of spiritual care competency. This was a quantitative cross-sectional study conducted among 155 nurses from SASMEC IIUM using self-administered questionnaires, which included sociodemographic factors, Spiritual Care Competency Scale (SCCS). Descriptive statistics, Chi Square Test, and Pearson Correlation Test were used in data analysis via SPSS version 27. The majority of the nurses in SASMEC IIUM perceived high levels of competency (99.4%). The highest mean difference among the domains were assessment and implementation of spiritual care, (MD=12.368), and personal support and patient counseling (MD=12.368) while the lowest mean difference was communication (MD=4.155). Furthermore, there was no significant relationship between spiritual care competence and sociodemographic factors (age, marital status, educational level, nurses' experience, race, religion, and previous participation in training spiritual care programs), except for gender (p<0.05) in which female acquired higher competency level than male. This study may help healthcare organizations and educational institutions to develop and implement strategies in enhancing and polishing the standard of spiritual care among nurses. Future studies are recommended to explain the natural association between sociodemographic factors and spiritual care competence.

Demographic and Clinical Characteristics of Neonates at Risk of Gentamicin-induced Nephrotoxicity: A Single-Center Study in Sabah Women and Children Hospital

Lisa Pei Ling Lee — 2026-01-05

Gentamicin is a clinically valuable aminoglycoside for the treatment of pneumonia, urinary tract infection, and neonatal sepsis empirically. The recommended dosage for gentamicin in pediatric guidelines is 4-7mg/kg in an extended interval of every 24-hourly or 36-hourly based on the subjects’ gestational age. This study aimed to describe the demographic and clinical characteristics of neonatal and pediatric patients that were at risk of gentamicin-related nephrotoxicity. This was a descriptive study conducted on all under 12-year-old pediatric patients who were on 5mg/kg gentamicin extended interval regimens and had elevated blood gentamicin trough levels of above 1.0mg/L. Out of the total 46 subjects, 24 were preterm babies and 27 had body weight of less than 2.5kg. The subjects were categorized into 2 groups: the 24-hourly group and the 36-hourly group. There were 32 (69.6%) subjects in the 24-hourly group and 14 (30.4%) in the 36-hourly group. 21 out of 32 subjects in the 24-hourly group were term babies whereas, all subjects in the 36-hourly group were preterm babies. Of all the 46 cases, gentamicin was served during the babies’ first week of life in 31 cases, and after the babies’ first week of life in 15 cases with 1 case of gentamicin being served to infants of 1 month old and above. It appeared that the incidence of gentamicin-related nephrotoxicity was slightly lower in the 36hourly group than the 24-hourly group. It is recommended to use the 5 mg/kg 36 hourly regimen for neonates in their first week of life when indicated.

Knowledge, Attitude and Practice Among Overweight Patients in General Medical Clinic, Hospital Queen Elizabeth

Kalaiarasan Gemini — 2026-01-05

Obesity is a complex and an epidemic disease distributed among all age groups. Knowledge, attitude and practice (KAP) studies are largely used to understand the disease burden in a certain population. Thus, the aim of this study is to evaluate KAP of overweight patients in an urban tertiary centre setting and test the validity of the questionnaire used to assess the KAP. This hospital-based cross-sectional study involves 113 overweight patients based on Asia Pacific Body Mass Index (BMI) scale aged 12 to 50 years old attending the general medical clinic in Hospital Queen Elizabeth, Sabah. Patients were chosen based on convenience sampling with a calculates sample size of 93. Sociodemographic details and BMI awareness were gathered after obtaining patient’s consent. For the assessment of attitude and preparedness level of patient to lose weight, a modified Likert scale questionnaire was used. Sociodemographic data and the stage of readiness were analysed based on the mean distribution and standard deviation. Chi-square tests, Fisher exact tests and One-Way ANOVA tests were used to see the correlation between basic sociodemographic data namely age, gender, race, education level, and BMI with awareness. Subsequently, Chi-square test and One-Way ANOVA tests was used to assess the correlation of BMI classification, BMI awareness level and their preparedness to enrol to weight loss program based on stage of readiness. In addition, to find out the influence of BMI awareness level and BMI classification on response to each question from the Likert scale questionnaire, analysis using Chi-square test was done. Finally, the reliability and validity of the questionnaire was tested from two statistical validity point of view with the first using predictive validity via multiple regression (Criterion Validity) and second calculating the Cronbach’s alpha coefficient (reliability) as well as the convergent and discriminant validity (Construct Validity). Predominant involvement of female participants and obesity class 2 stage were observed overall. Only 53% of the obese class respondents were aware of their BMI with all the pre-obese class patients being unaware of their BMI signifying the poor awareness. Statistically, only BMI and gender has a significant correlation with awareness. (p<0.001, p=0.048) Majority of the patients were grouped under the stage of preparation and above but no significant association analysed towards BMI awareness level. (n:109, 96%) Notably, significant correlations were found between question 4 and BMI awareness level (F=4.485, p=0.036) as well as question 3 and BMI class (F=3.364, p=0.0038). The questionnaire used was deemed valid and reliable by confirming the internal consistency using Cronbach’s alpha (α=0.69) and assessing the convergent and discriminative validity (0.3<r<0.7). All the questionnaire variables were statistically significant, marking the predictive validity of the questionnaire. F (5, 107) = 59.928, p < 0.001, R² = 0.737. This study identifies most of the patient in an urban setting belongs to obese class with poor awareness on their BMI scale despite majority of them being prepared to lose weight. Applying the validity of the questionnaire, this small-scale study concludes the need of awareness teaching to aid in obesity prevention.