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Awareness of Project Ota - Birthmark Reduction by IDO'S Clinic.


Launching at JB Region


“Project Ota” is a one of its kind pro bono project initiated by IDO’S Clinic as part of Corporate Social Responsibility. This project aims in helping the less fortunate patients with Nevus of Ota, a disfiguring birthmarks on the face, by providing free treatments to those who are unable to afford basic laser treatment care.  

The Project will be divided in 3 stages
Stage 1 : Identify the eligible candidates for the treatment.
Stage 2 : Initiate the treatments at our centers across Malaysia.
Stage 3 : Follow up on the candidates at the end of the treatment.

Relevance Nevus of Ota is a subtype of birthmarks on the face. There is no official statistic pertaining to its prevalence in Malaysia and the closest number is adopted from Japanese population, which affects up to 6 people for every 1,000 population. Thereby, using below the lowest percentage of this statistic, we can perhaps postulate that there are about 30,000 (based on a rate of 0.1%) affected people in Malaysia.

Negative psychological impact of Nevus of Ota on the development of an affected child is way greater than the physical impact of the condition. Despite being a fairly common occurrence, many people without the birthmarks will shun an affected child; for fear that it is contagious or harmful to them in some ways.

Nevus of Ota is surrounded by misinformation, misperception, mystery, cultural myths and negative stereotypes. Unfortunately and sadly that, many affected young children are still being socially stigmatized for the lack of public information. One of the many significant statements that we have heard from our patients in relation to the birthmarks include “The mark of devil” or “The sins of the mother”, which have often lead to the feeling of fear, guilt amongst the victims and their mothers. 
Numerous clinical and non-clinical literatures have reported high
incidence of affected children that develop low self-esteem; psychological conditions such as depression, anxiety and anti-social behaviour; performed poorly in both academic and extra-curriculum. This in turn leads to a long-term disadvantage on the development of the affected child.

The Objectives:
1) Identify 100-150 children with Nevus of Ota across Malaysia whom
family has difficulty funding the treatment. IDO’S Clinic will sponsor the full cost of each treatment, estimated at about RM10,000 per child.
2) To increase the public awareness about Nevus of Ota and to correct general public’s stigmata on Nevus of Ota

Background of Nevus of Ota
Nevus of Ota, a subtype of birthmarks on the face. It was originally described by Dr. Masao Ota, a professor of dermatology from Japan in 1939. It presents as a blue or gray patch on the face, which is within the distribution of the areas supplied by ophthalmic and maxillary branches of the trigeminal nerve. 
Causes
The exact cause remains unknown to date. 
Although unconfirmed, specific mutations have been detected within the skin. It is also believe that Nevus of Ota may represent melanocytes (melanin producing cells) that got trapped within the upper 3rd of the dermis during birth.
As the peak age of onset of Nevus of Ota is found in early infancy and in early adolescence, hormone might be a factor in the development of this condition.

Male-to-female ratio is 1 : 4.8 for nevus of Ota. 50% of cases present at birth. The 2nd peak of onset is seen during adolescence. Few cases of delayed-onset that first appear in adults, including in older patients, have been reported.

Nevus of Ota most frequently presents as blue-to-gray pigmented patch affecting the forehead, temple, cheek area and/or around the eye. (Distribution of trigeminal nerve). Some cases involve the mouth lining and eyes.
Most cases of nevus of Ota are one-sided (90%), although pigmentation is present at both side of the face in 5-10% of cases.
After onset, nevus of Ota may progressively enlarge and darken in color, and its appearance usually remains stable once adulthood is reached. 
The perception of the color of nevus of Ota may fluctuate according to personal and environmental conditions, such as fatigue, menstruation, insomnia, and cloudy, cold, or hot weather conditions

Complication
Nevus of Ota can cause facial disfigurement, resulting in emotional and psychologic distress. Often, child will grow up with dampened confidence and self-esteem, resulting in negative developments in life.
In rare cases, melanoma, which can be life threatening, has been reported to arise from nevus of Ota. 
Glaucoma (10.3%) and other eye abnormalities also have been associated with nevus of Ota.
Project Method Stage 1 (Recruitment)

“Project Ota” will be concluded by a reunion of all the candidates who have successfully treated for their Nevus of Ota in 2016. It is hoping to extend this experience to offer more pro-bono treatments to other conditions such as other subtypes of birthmarks and tattoo removal.

Inclusion
Criteria
1) Malaysian Citizen
2) Age between 12-20 with no personal source of income
3) Total household income of less than RM4000.
4) Must be able to attend the interview and all subsequent treatments that are performed at IDO’S Clinic.

Verifications needed
 Candidate’s IC & Certificate of Birth
 Parents’ Income Tax Slip 2013 and 2014  2 months latest pay slip of parents.

Exclusion
Criteria
1) Fitzpatrick Skin Type 4 and above (dark skin tone)
2) Possess skin or medical conditions that are contra-indicated for laser treatments.
Treatment
Method
Q-switched ND:YAG Laser at monthly interval. Approximately 10-15 treatments are needed depending on its severity and the location.
Q-switched ND:YAG laser utilizes PhotoAcoustic Technology Pulse (PTP) to deliver very high peak energy to vibrate the fragment the pigments. The shattered pigments will be absorbed by the body’s natural defense system and eliminated via our metabolism.
Most patients will feel the laser pulses as quick tingling sensations, like very tiny rubber bands snapped against the skin. Anesthetic may be applied prior to the treatment for maximum comfort. The procedure usually lasts between 10 to 20 minutes.
Laser procedure is safe. There is a possibility of mild flushing that should resolve after 30 minutes. More obvious reactions such as localized redness, swelling or bruises may occur with intensive treatments, which will resolve after few days. Most patients can resume their daily routine immediately after the treatment. 

Location of IDO’S Clinic
1) A-16-1, Lorong Bayan Indah 4, 11900 Bayan Lepas, Pulau Pinang. Tel: 012-4125992
2) No. 9, Jalan Mahagoni 5/KS 7, 
 Bandar Botanic, 41200 Klang,Selangor. Tel: 017-5084992
3) Lot No. C6-G, Block C, Setia Walk,
 Persiaran Wawasan, Pusat Bandar Puchong, 
 47160 Puchong, Selangor. Tel: 03-58793851
4) No.16-G, Jalan PJU 5/9, Dataran Sunway,
 Kota Damansara,47810, Selangor. Tel: 017-4861992
5) No. 19, Jalan Persiaran Flora Utama,
 Taman Flora Utama, 83000 Batu Pahat, Johor. Tel: 012-7288992
6) Lot 1-60, 1st Floor, Kluang Mall,
 Jalan Rambutan, Bandar Kluang, 86000 Kluang, Johor.  Tel: 012-7087992
7) No. 172, 173, Jalan Kenanga 29/4, Bandar Indahpura, 
 81000 Kulai Jaya, Johor. Tel: 012-7785992
8) No. 131, Jalan Sutera Tanjung 8/2, Taman Sutera Utama, 81300 Skudai, Johor. Tel: 012-6455991
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