When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.

The COVID-19 pandemic affected institution of higher learning as some teaching and learning activities had to halt due to safety of the students and staff. Face to face teaching was stopped, and lecturers had to find other methods of teaching. Online teaching was the only allowed method. The methods were synchronous and asynchronous. Lecturers have had to find innovative ways to practice effective teaching methods. Assessments had to also be done online taking important factors into consideration, following steps given by authorities. This article discusses issues around medical teaching during the COVID-19 pandemic Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 77-S 81

During the first phase of the Movement Control Order, many medical lecturers had difficulty adapting to the online teaching and learning methods that were made compulsory by the institutional directives. Some of these lecturers are clinicians who need to juggle between clinical work and teaching, and consider a two-week adaptation during this period to be not enough. Furthermore, converting traditional face-to-face learning to online formats for undergraduate and postgraduate clinical programmes would reduce the learning outcomes, especially those related to clinical applications and the acquisition of new skills. This editorial discusses the impact that movement restrictions have had on medical teaching and learning, the alternatives and challenges and the way forward.

Mucocele is a mucous filled benign cystic lesion. It develops due to obstruction of any natural os-tium of the paranasal sinus. Even though being benign, it has capability to erode and cause thinning the adjacent bony structures. Isolated intraorbital mucocele without paranasal sinus disease is a rare condition. We present a 39-year-old female patient with right medial canthal swelling without any nasal symptoms, and normal nasoendoscopic finding. Imaging revealed the lesion as a right ethmoidal mucocele with normal paranasal sinuses. However intraoperatively, it was an isolated intraorbital lesion, lateral to lamina papyracea with thick-yellowish mucin discharge.

COVID-19 has taken the world by storm: since the first few cases appeared in Wuhan, China in December 2019 and by June 2020 there were more than 10 million cases of COVID-19 cases worldwide. Malaysia had its first case in January 2020 and acted promptly by implementing several drastic measures to contain the disease. Subsequently, the Ministry of Health Malaysia has implemented guidelines and recommendations on the management of COVID-19. The Department of Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) provides services for patients with ear, nose, throat, head and neck diseases and provides audiology, speech and language therapy, as well as undergraduate and postgraduate training. As the department’s staff is heavily involved in examinations and interventions of upper aerodigestive tract problems, the challenges are distinctly different from other specialties. This article discusses how COVID-19 affected ORL-HNS services and what measures were taken in Hospital Melaka, Malaysia.

Objective: Mucositis is a debilitating complication of radiotherapy treatment in nasopharyngeal carcinoma (NPC). Mucositis can lead to malnutrition due to poor oral intake, and the cancer treatment protocol might be postponed due to this condition. Until now, there is no specific treatment to prevent radiotherapy-induced mucositis in NPC patients. The usage of propolis mouthwash is believed to be one of the important remedies to reduce the severity of mucositis in the future. We sought to evaluate the effectiveness of propolis mouthwash in preventing radiotherapy-induced mucositis in NPC patients.Methods: This is a double arm, prospective, randomized control trial (RCT) with intervention involving 17 patients diagnosed with NPC attending ORL-HNS clinic in Institut Perubatan & Pergigian Termaju (IPPT) Bertam. 10 patients were given propolis mouthwash and another 7 patients were given normal saline mouthwash as a placebo. The effectiveness of propolis mouthwash was assessed by repeated measures ANOVA.Result: All 17 NPC patients were randomly divided into propolis group (intervention) and normal saline group (placebo). 10 patients were given propolis mouthwash and another 7 patients were given normal saline mouthwash. Comparison of adjusted mean and 95% confidence interval of mucositis grading score between propolis mouthwash and normal saline showed at the second week was 0.10(- 0.13, 0.33) vs 1.14(0.31, 1.98), fourth week: 0.50(0.12, 0.88) vs 2.00(1.47, 2.53), and sixth week: 1.20(0.90, 1.50) vs 2.86(2.51, 3.21), respectively. Repeated measures ANOVA showed P<0.001, indicating a significant improvement of mucositis grading between propolis and normal saline group.Conclusion: Propolis mouthwash is proved to be effective in reducing the severity of radiotherapyinduced mucositis in NPC patients and it is safe to be used. Therefore, its use is recommended as an adjunct treatment during the treatment protocol of NPC.International Journal of Human and Health Sciences Supplementary Issue: 2022 Page: S41

Mantle cell lymphoma (MCL) is a rare, aggressive subtype of non-Hodgkin lymphoma with a poor prognosis and high recurrence rate. It seldom affects the Waldeyer’s ring let alone the nasopharynx. Patients usually present at late stages of the disease leading to poor failure-free and overall survival rates. Intensive chemotherapy regimes and autologous stem cell transplantation have reported increased survival rates. We report a relapsed case of nasopharyngeal MCL, which previously occurred in the gastrointestinal tract. The patient had undergone a hemicolectomy for colon intussusception secondary to the intraluminal lymphoma mass. He was unable to complete the treatment regime for MCL due to the adverse side effects. Oropharyngeal mass was discovered during routine outpatient follow-up, which was confirmed as nasopharyngeal MCL. We discuss the prognosis, disease progression, and possible treatments.

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