Microcomputed-Tomographic Analysis of the Root Canal Morphology of the Mandibular First Molars in a Malaysian Subpopulation Using Two Classification Systems / Análisis por Tomografía Microcomputada de la Morfología del Conducto Radicular de los Primeros Molares Mandibulares en una Subpoblación de Malasia Utilizando dos Sistemas de Clasificación

SUMMARY: This work investigated the morphology of the root canal system of the mandibular first molar in a Malaysian subpopulation. Using micro-computed tomography with an isotropic resolution of 22 µm, 140 mandibular first molars were scanned. MIMICS software was used for segmentation, 3-D reconstruction and analysis of the acquired images. The canal configuration was described using Vertucci [supported by the supplementary configurations proposed by Sert & Bayirli (2004)] and Ahmed et al. (2027), coding systems. The chi-square test was used to assess the association between qualitative variables. By non-considering intercanal communications, Vertucci types IV (17.1%) and I (76.4%) were the most frequently reported configurations in the mesial and distal roots, respectively. Of the reported configurations, 24.3% and 4.3% were non-classifiable by Vertucci system in the mesial and distal roots, respectively. Up to 63.6% and 9.3% of the reported configurations were non- classifiable, and type I was the most frequent when considering intercanal communications (7.1% and 76.4% in the mesial and distal roots, respectively). According to Ahmed et al., system, almost half of the sample had more than four digits (47.9%), followed by the 3-digits category (20.71%). In both systems, a significant association was found between the canal configuration and the root type (p<0.001). The mandibular first molar of this Malaysian subpopulation demonstrated a wide range of root canal morphology. When compared to the Vertucci system, the system developed by Ahmed et al., successfully classified all molars configurations despite their level of complexity. The complex canal anatomy of mandibular first molars in this subpopulation warrants special attention during root canal treatment procedures.

En este trabajo se investigó la morfología del sistema de conductos radiculares del primer molar mandibular en una subpoblación de Malasia. Utilizando tomografía microcomputada con una resolución isotrópica de 22 µm, se escanearon 140 primeros molares mandibulares. Se utilizó el software MIMICS para segmentar (enmascarar), reconstruir en 3D, visualizar y analizar las imágenes adquiridas. La configuración del canal se describió utilizando Vertucci respaldado por las configuraciones complementarias propuestas por Sert & Bayirli (2004)] y Ahmed et al. (2017, 2020), sistemas de codificación. Se utilizó la prueba de chi-cuadrado para evaluar la asociación entre variables cualitativas. Sin considerar las comunicaciones intercanales, los tipos Vertucci IV (17,1%) y I (76,4%) fueron las configuraciones reportadas con mayor frecuencia en las raíces mesiales y distales, respectivamente. De las configuraciones reportadas, el 24,3 % y el 4,3 % fueron no clasificables por el sistema de Vertucci en las raíces mesial y distal, respectivamente. Hasta el 63,6 % y el 9,3 % de las configuraciones reportadas fueron no clasificables, siendo la tipo I la más frecuente al considerar las comunicaciones intercanales (7,1 % y 76,4 % en las raíces mesiales y distales, respectivamente). Según Ahmed et al. (2017, 2020) en el sistema, casi la mitad de la muestra tenía más de cuatro dígitos (47,9 %), seguido por la categoría de 3 dígitos (20,71 %). En ambos sistemas se encontró una asociación significativa entre la configuración del canal y el tipo de raíz (p<0,001). El primer molar mandibular de esta subpoblación de Malasia demostró una amplia gama morfológica del conducto radicular. En comparación con el sistema Vertucci, el sistema desarrollado por Ahmed et al. (2017, 2020) clasificaron con éxito todas las configuraciones de los molares a pesar de su nivel de complejidad. La compleja anatomía del canal de los primeros molares mandibulares en esta subpoblación merece una atención especial durante los procedimientos de tratamiento de conducto.

Analyzing complaints of arm, neck, and shoulder pain among academicians in Malaysia: a cross-sectional study on prevalence and contributing factors / Analisando queixas de dores nos braços, pescoço e ombros entre acadêmicos na Malásia: um estudo transversal sobre prevalência e fatores contribuintes

OBJECTIVES: Complaints of arm, neck, and shoulder (CANS) have been recognized as an important cause of work disability. Therefore, it is essential to identify those health risk factors for the development of CANS before they escalate into a disabling musculoskeletal condition. This study aims to ascertain the association between individual, physical, and psychosocial risk factors and the occurrence of CANS among academics in Malaysia. METHODS: A cross-sectional study design was adopted, enrolling 296 academic staff working at a private university in Malaysia using a convenient sampling approach. A content-validated questionnaire was distributed among selected academic staff to gather their feedback on the prevalence and contributing factors of CANS, and the survey was conducted for a period of six months. The chi-square test was used to analyze the association between risk factors and CANS, and multiple logistic regression was used to predict the risk factors of CANS. This study links all the health risk factors to CANS in Malaysian academicians. RESULTS: Of the academic staff who participated in this study, 63.5% reported an annual prevalence of CANS. Physical risk factors, including work experience, adopting a static head-down posture, time spent per day in teaching, and the number of hours spent in front of a computer, are associated with CANS (p<0.05). However, the utility of back support (p=0.878) and footrests (p=0.078) does not show any association with the occurrence of CANS (p>0.05). Besides job demand, other psychosocial factors do not show any significant association with CANS. DISCUSSION: The study found that 63.5% of academic staff suffer from arm, shoulder and neck pain, which is linked to physical risk factors such as work experience, static posture, teaching time and computer use. Back support and footrests had no significant influence on the complaints. Addressing physical risk factors is key to reducing these conditions among academic staff.

OBJETIVOS: As queixas do braço, pescoço e ombro (CANS, na sigla em inglês) foram reconhecidas como uma importante causa de incapacidade no trabalho. Portanto, é essencial identificar aqueles fatores de risco para a saúde para o desenvolvimento de CANS antes que elas se tornem uma condição musculoesquelética desabilitante. Este estudo visa determinar a associação entre fatores de risco individuais, físicos e psicossociais e a ocorrência de CANS entre acadêmicos na Malásia. METODOS: Um projeto de estudo transversal foi adotado, matriculando 296 funcionários acadêmicos que trabalham em uma universidade privada na Malásia usando uma abordagem de amostragem conveniente. Um questionário validado pelo conteúdo foi distribuído entre os funcionários acadêmicos selecionados para reunir os seus comentários sobre a prevalência e os fatores que contribuíram para a doença, e o inquérito foi conduzido por um período de seis meses. O teste Chi-square foi usado para analisar a associação entre os fatores de risco e as CANS, e regressão logística múltipla foi utilizada para predizer os fatores de risco de CANS. Este estudo vincula todos os fatores de risco para a saúde às CANS em acadêmicos da Malásia. RESULTADOS: Dos acadêmicos que participaram deste estudo, 63.5% relataram uma prevalência anual de CANS. Os fatores de risco físicos, incluindo a experiência de trabalho, a adoção de uma postura estática de cabeça para baixo, o tempo gasto por dia no ensino e o número de horas passadas na frente de um computador, estão associados com CANS (p<0.05). No entanto, a utilidade do suporte traseiro (p=0.878) e dos suportes de rodapé (p =0.078) não mostra nenhuma associação com a ocorrência de CANS (p>0.05). Além da procura de emprego, outros fatores psicossociais não mostram qualquer associação significativa com a CANS. CONCLUSÃO: O estudo constatou que 63,5% dos docentes sofrem de dores nos braços, ombros e pescoço, o que está ligado a fatores de risco físicos, como experiência de trabalho, postura estática, tempo de ensino e uso do computador. O apoio para as costas e os apoios para os pés não tiveram influência significativa nas queixas. Abordar os fatores de risco físicos é fundamental para reduzir estas condições entre o pessoal acadêmico.

Oral health knowledge, attitude, practice, perceptions and barriers to dental care among libyan parents / Conocimiento, actitud, práctica, percepciones y barreras para el cuidado dental en salud bucal entre los padres libios

Aim: To assess parental oral health knowledge, attitude, practice (KAP), perceptions of their children's oral health status, and explore the barriers to dental care utilization among Libyan parents living in Malaysia. Material and Methods: A cross-sectional study was conducted among Libyan parents of children aged 1- 7 years old who lived in Malaysia. A 63-items questionnaire was constructed, validated, and pretested. Six hundred self-administered questionnaires were distributed Data were analyzed using IBM SPSS version 22.0. A generalized Linear Model was used to test the possible relationships between KAP scores and different sociodemographic factors. A significant level for all the statistical tests was predetermined at p≤0.05. Results: A total of 381 questionnaires were included, of which fathers' responses constituted 189 (49.6%), and mothers' responses constituted 192 (50.4%). Most of the parents exhibited good oral health knowledge (77.2%), positive attitudes (86.4%), and were adherent to good oral health practice (78.7%) with mean values of 10.6 (SD=1.8), 9.5 (SD=1.5), and 7.9 (SD=1.4) respectively. Gender, age, and income had statistically significant relationships (p<0.05) with KAP scores. The majority (81.1%) of parents rated their child's oral health as good. More than one-third of parents (35.7%) perceived no need for dental care, and 18.6% perceived no need to treat the primary teeth as they will be replaced. Conclusion: Good Knowledge and positive attitudes towards oral health are not necessarily translated into favorable practices. The lack of perceived need and low value attributed to primary teeth created barriers to seek dental care services among the majority of surveyed parents. Attention must be directed to behavior change strategies rather than providing oral health education alone to improve the children's oral health outcomes.

Objetivo: Evaluar el conocimiento, la actitud y la práctica de la salud bucal de los padres (CAP), las percepciones del estado de salud bucal de sus hijos y explorar las barreras para la utilización de la atención dental entre los padres libios que viven en Malasia. Material y Métodos: Se realizó un estudio transversal entre padres libios de niños de 1 a 7 años que vivían en Malasia. Se construyó, validó y probó previamente un cuestionario de 63 ítems. Se distribuyeron 600 cuestionarios autoadministrados. Los datos se analizaron con IBM SPSS versión 22.0. Se utilizó un modelo lineal generalizado para probar las posibles relaciones entre las puntuaciones KAP y diferentes factores sociodemográficos. Se predeterminó un nivel de significancia para todas las pruebas estadísticas en p? 0,05. Resultados: Se incluyeron un total de 381 cuestionarios, de los cuales las respuestas de los padres constituyeron 189 (49,6%) y las respuestas de las madres 192 (50,4%). La mayoría de los padres exhibieron buenos conocimientos sobre salud bucal (77,2 %), actitudes positivas (86,4 %) y se adhirieron a buenas prácticas de salud bucal (78,7 %) con valores medios de 10,6 (DE=1,8), 9,5 (DE=1,5) , y 7,9 (DE=1,4) respectivamente. El género, la edad y los ingresos tuvieron relaciones estadísticamente significativas (p<0,05) con las puntuaciones KAP. La mayoría (81,1%) de los padres calificaron la salud bucal de sus hijos como buena. Más de un tercio de los padres (35,7%) no percibieron la necesidad de atención dental y el 18,6% no percibieron la necesidad de tratar los dientes primarios, ya que serán reemplazados. Conclusión: El buen conocimiento y las actitudes positivas hacia la salud bucal no necesariamente se traducen en prácticas favorables. La falta de necesidad percibida y el bajo valor atribuido a los dientes primarios crearon barreras para buscar servicios de atención dental entre la mayoría de los padres encuestados. La atención se debe dirigir a las estrategias de cambio de comportamiento en lugar de brindar educación sobre salud bucal únicamente para mejorar los resultados de salud bucal de los niños.

Reproductive health practices and use of health services among immigrant Indonesian women working in Malaysia

ABSTRACT OBJECTIVE To describe the reproductive health practices of immigrant Indonesian women working in Malaysia and their accessibility to health services. METHODS A cross-sectional study using a validated self-administered questionnaire was conducted with 593 immigrant Indonesian workers who stayed in Malaysia for at least six months and within the reproductive age group. RESULTS About 13.5% of the respondents have used health facilities for reproductive health-related problems. Less than half of the respondents preferred to use public health facilities. Only 15% used treatment available in health facilities related to irregular menstrual cycles (34.6%), severe dysmenorrhea (58.7%) and nonspecific symptoms related to menstruation (31.7%). Family planning services were the most required health service. However, only 31.5% met the needs for family planning services. One-third of the respondents had sexual reproductive health problems and required treatment, but only 9.9% sought reproductive health services when needed. CONCLUSIONS Strategies to improve the accessibility to sexual reproductive health services requires a collaboration between the Indonesian government representatives in Malaysia and non-governmental organizations to address the reproductive health issues among immigrant Indonesian women in Malaysia. Health policy related to immigrant workers is needed in order to enhance the accessibility to women's health needs for universal health coverage.

Factors Associated with Oral Health Literacy among Patients with Type 2 Diabetes Mellitus Attending Hospital Universiti Sains Malaysia

Abstract Objective: To determine the oral health literacy (OHL) level and its associated factors among patients with type 2 diabetes mellitus attending Hospital Universiti Sains Malaysia (USM). Material and Methods: This cross-sectional study involved 135 diabetic patients with a mean age of 62.6 years old (SD=9.05) who attended the Diabetes Outpatient Clinic at Hospital USM, a teaching hospital in the north-eastern corner of Peninsular Malaysia. The Malay version of the Oral Health Literacy Instrument (OHLI-M) was used to assess the level of OHL among respondents. An additional self-administered questionnaire was used to obtain other variables of interest. Systematic random sampling was applied in this study. The data were analyzed using an independent t-test and ANOVA to determine factors associated with oral health literacy among respondents. Results: Most respondents have at least one oral health problem (62.2%). The most common problem was cavitated tooth (42.2%). Other problems include toothache (17.8%), mobile tooth (17.8%), and swollen gums (16.3%). OHL level for most respondents (40.7%) was inadequate. The mean total OHLI-M score was 67.9 (SD=17.74). The OHL score was significantly lower in respondents with the following characteristics: female, no formal education or had primary education, unemployed, lower income group, never visited a dentist, and had swollen gums. Conclusion: The OHL of most patients with type 2 diabetes mellitus attending the Diabetes Outpatient Clinic, Hospital USM still need to be improved. Oral health problems were common in patients with type 2 diabetes mellitus in this study. This study also highlighted the link between OHL and socio-demographic factors. Improving the OHL of patients may increase their capability to obtain and understand oral health messages needed to take appropriate actions that will eventually prevent oral diseases associated with diabetes mellitus (AU).

Assessing the racial differences in Q angle measurements in relevance to articular cartilage of the femoral condyle: a retrospective ultrasound study / Evaluación de las diferencias raciales en las mediciones del ángulo Q en relación con el cartílago articular del cóndilo femoral: un estudio ecográfico retrospectivo

SUMMARY: The Q-angle is defined as the acute angle formed by the vectors for combined pull of the quadriceps femoris muscle and the patellar tendon. This study aimed to investigate the variations in Q angle with respect to race. Moreover, this study performed ultrasound to evaluate of the thickness of articular cartilage covering the medial and lateral femoral condyle in volunteers with an increased Q angle. The study included 487 Jordanian and 402 Malaysians with age range 18-23 years. Moreover, the study included 30 participants aged between 18 and 22 years, with a total of 15 volunteers with Q >14° and 15 patients with Q ≤14°. Both Q angle and condylar distance were measured by well-trained medical practitioners according to a well-established protocol. The thickness of articular cartilage covering the medial and lateral femoral condyle of the femoral bone was measured using ultrasound. Regardless of race, Q angle was greater in females. Furthermore, Q angle was significantly greater in Arab volunteers compared to Malay volunteers. Q angle significantly increase with increasing condylar distance in both races. Finally, the statistical analysis showed a significantly reduced thickness of articular cartilage on both medial and lateral femoral condyle (P = 0.05) in the Q >14° group. Multiple factors including race and condylar distance and even the articular cartilage of femoral condyle should be considered during the examination and management of knee fractures and condylar diseases.

RESUMEN: El ángulo Q se define como el ángulo agudo formado por los vectores de tracción combinada del músculo cuádriceps femoral y el tendón patelar. Este estudio tuvo como objetivo investigar las variaciones en el ángulo Q con respecto a la raza. Además, se realizó una ecografía para evaluar el grosor del cartílago articular que cubre los cóndilos femorales medial y lateral en voluntarios con un ángulo Q aumentado. El estudio incluyó a 487 jordanos y 402 malayos con un rango de edad de 18 a 23 años. Además, el estudio incluyó a 30 participantes con edades comprendidas entre 18 y 22 años, 15 voluntarios con Q> 14 ° y 15 pacientes con Q ≤ 14 °. Tanto el ángulo Q como la distancia condilar fueron medidos por médicos bien entrenados de acuerdo con un protocolo establecido. El grosor del cartílago articular que cubre los cóndilos femorales medial y lateral del fémur se midió mediante ecografía. Independientemente del grupo racial, el ángulo Q fue mayor en las mujeres. Además, el ángulo Q fue significativamente mayor en los voluntarios árabes en comparación con los voluntarios malayos. El ángulo Q se aumenta significativamente al incrementarse la distancia condilar en ambas grupos raciales. Finalmente, el análisis estadístico mostró una reducción significativa del grosor del cartílago articular en los cóndilos femorales medial y lateral (P = 0,05) en el grupo Q> 14. Durante la exploración y el tratamiento de las fracturas de rodilla y de las enfermedades condilares, se deben considerar múltiples factores, incluida la raza y la distancia condilar e incluso el cartílago articular del cóndilo femoral.

Preditores de videogames para dispositivos móveis na dor do músculo esquelético entre estudantes universitários em Selangor, Malásia / Predictors of Mobile Video Gaming on Musculoskeletal Pain among University Students in Selangor, Malaysia

OBJETIVOS: Jogar videogames em dispositivos móveis tem aumentado rapidamente entre estudantes universitários, mais do que antes da pandemia do COVID-19. Isso é muito preocupante, pois pode desencadear vários problemas, como dores musculoesqueléticas e distúrbios de jogo. Vários estudos semelhantes foram realizados em vários países, mas limitados na Malásia. O presente estudo tem como objetivo investigar o efeito dos videogames móveis na dor musculoesquelética entre estudantes universitários em Selangor, Malásia. PARTICIPANTES E MÉTODOS: Este estudo foi conduzido online usando um questionário online auto-relatado por meio do Formulário Google e enviado a estudantes universitários em Selangor, Malásia. O vício em jogos dos participantes foi medido por meio do questionário Ten Item Internet Gaming Disorder test (IGDT-10) e a prevalência de dor musculoesquelética foi avaliada pelo Modified Nordic Musculoskeletal Questionnaire (MNMQ). RESULTADOS: A prevalência de Transtorno de Jogos na Internet entre estudantes universitários em Selangor, Malásia, é de 1,8% (n = 3). A região do pescoço (74,2%) foi a região do corpo mais comumente relatada com dor musculoesquelética, seguida pela região dos ombros (60,7%), região lombar (55,8%) e região superior das costas (50,9%). Houve associação significativa entre a posição corporal durante o videogame móvel (p = 0,002) e a dor musculoesquelética na região lombar. CONCLUSÃO: De acordo com os resultados deste estudo, a prevalência de Transtorno de Jogos na Internet entre estudantes universitários era baixa e não viciados em jogos no bloqueio Covid-19. Também descobrimos que os participantes que se sentaram enquanto jogavam videogames para celular tinham maior probabilidade de desenvolver dor lombar.

INTRODUCTION: Mobile video gaming among university students has increased rapidly, more than before the COVID-19 pandemic. This is very concerning as this could spark various problems, such as musculoskeletal pain and gaming disorders. OBJECTIVES: The present study is to identify the predictors of mobile video gaming on musculoskeletal pain among university students in Selangor, Malaysia. PARTICIPANTS AND METHODS: This study was conducted online using a self-reported online questionnaire via Google Form and sent to university students in Selangor, Malaysia. Participants' gaming addiction was measured using the Ten Item Internet Gaming Disorder Test (IGDT-10) questionnaire, and the prevalence of musculoskeletal pain was assessed by the Modified Nordic Musculoskeletal Questionnaire (MNMQ). The data was analyzed using SPSS version 25. A descriptive and binomial linear regression test was used to predict the variables. The statistical significance was set at p < 0.05, and odds ratios were calculated with confidence intervals of 95%. RESULTS: The prevalence of Internet Gaming Disorder among university students in Selangor, Malaysia is 1.8% (n=3). The neck region (74.2%) was the most commonly reported body region with musculoskeletal pain, followed by the shoulder region (60.7 %), lower back region (55.8 %), and upper back region (50.9 %). The body position was the only predictor of mobile video gaming with musculoskeletal pain (p = 0.002) in the lower back region. CONCLUSION: According to the findings of this study, the prevalence of Internet Gaming Disorder (IGD) among university students was low and not addicted to gaming in the Covid-19 lockdown. We also found that participants who sat while playing mobile video games were more likely to develop low back pain. However, one of the limiting factors could be prolonged sitting in virtual classes during the lockdown, which causes low back pain.

Unique morphology of intraoperative measurement of distal femur in northern malaysian females and its correlation with total knee arthroplasty implant sizing / Morfología única de la medición intraoperatoria del fémur distal en mujeres del norte de malasia y su correlación con el tamaño del implante en artroplastia total de rodilla

SUMMARY: Accurate implant sizing is one of the major determinants in defining the success of total knee arthroplasty (TKA). Current TKA implants are based on Caucasian knee morphometry which is well documented to be larger than Asian knees. Even more, with regards to sizing, implant mismatch tends to be more evident in the female population. This study was designed to evaluate the distal femur dimensions of Malaysian female patients who underwent TKA in our institution and to compare them with the current prosthetic system in use. A total of 199 female patients (207 knees) who underwent TKA were enrolled in this study. Intraoperatively, the AP dimensions (medial and lateral condyles) and mediolateral (ML) width were measured. Known dimension of the femoral component of the prosthetic knee system currently in use were compared with the morphological data. The average femoral component overhang was 2.11 mm (SD 3.94 mm). There was significant difference between the mean ML width of the resected femur and the femoral component (p<0.01). Analysis also revealed a significant positive and weak relationship between both, AP (medial and lateral) and ML dimension. The aspect ratio (ML/AP) of the native femur was generally smaller than the implant aspect ratio which is likely to cause overhang in our population. In general, this study shows that the knees of our female sub-population are even narrower than the other Asian female knees from previous studies. Implants should be designed based on the morphological data of the local population. Implant manufactures should tailor them to accommodate a smaller change in ML width for an increment in the AP length and provide several ML widths for one AP length to obtain a better fitting prosthesis hence curbing the problem of ML overhang.

RESUMEN: El tamaño exacto del implante es uno de los principales determinantes para definir el éxito de la artroplastía total de rodilla (ATR). Los implantes de TKA se basan en la morfometría de rodilla caucásica, cuyo tamaño está reportado como mayor que las rodillas asiáticas. Más aún, en lo que respecta al tamaño, el desajuste de los implantes tiende a ser más evidente en la población femenina. Este estudio fue diseñado para evaluar las dimensiones del fémur distal de pacientes mujeres malasias que se sometieron a ATR en nuestra institución y compararlas con el sistema protésico actual. En este estudio se incluyeron un total de 199 pacientes (207 rodillas) que se sometieron a ATR. Intraoperatoriamente, se midieron las dimensiones AP (cóndilos medial y lateral) y el ancho mediolateral (ML). Se comparó la dimensión conocida del componente femoral del sistema protésico de rodilla actualmente en uso con los datos morfológicos. El voladizo o sobresaliencia del componente femoral fue de 2,11 mm (DE 3,94 mm). Hubo una diferencia significativa entre el ancho ML medio del fémur resecado y el componente femoral (p <0,01). El análisis también reveló una relación significativa positiva y débil entre las dimensiones AP (medial y lateral) y ML. La relación de aspecto (ML / AP) del fémur nativo fue más pequeña que la relación de aspecto del implante, lo que probablemente cause un voladizo en nuestra población. En general, este estudio muestra que las rodillas de nuestra subpoblación femenina son incluso más estrechas que otras rodillas de mujeres asiáticas reportadas en estudios anteriores. Los implantes deben ser diseñados en base a los datos morfológicos de la población local. Los fabricantes de implantes deben adaptarlos a un cambio más pequeño en el ancho de ML para un incremento en la longitud AP y proporcionar varios anchos ML para una longitud AP con el objetivo de obtener una prótesis de mejor ajuste y frenar el problema del voladizo ML.

External Apical Root Resorption and IL-1A, IL-1RN Gene Polymorphisms: A Systematic Review and Meta-Analysis of Prospective Studies

ABSTRACT Objective: To reconnoiter the IL-1A (-889) and IL-1RN (+2018) gene polymorphisms and their association with EARR. Material and Methods: The Science Direct, PubMed and Scopus databases were comprehensively searched by two independent reviewers. In addition, the bibliographies of all relevant publications and textbooks were searched manually. A meta-analysis was performed using data available up to May 9, 2020. Results: A total of 13 and 9 publications were selected for the systematic review and meta-analysis, respectively for both IL-1A and IL-1RN genes. Odds ratio (OR) was used to evaluate the association of the gene polymorphism and the risk of EARR. The risk of EARR was estimated using the overall OR from the published studies. No association was found for IL-1A gene for the risk of EARR. However, the dominant and co-dominant models of IL-1RN gene polymorphism were associated with the risk of EARR. Conclusion: More studies are warranted to determine the relationship between IL-1A and IL-1RN gene polymorphisms and EARR for a clearer understanding of their interactions.

Association of Socio-Demographic and Clinicopathological Risk Factors with Oral Cancers: A 19-Year Retrospective Study

ABSTRACT Objective: To determine the association of socio-demographic and clinic-pathological risk factors with oral cancer in Kelantan, Malaysia. Material and Methods: A 19-year cross-sectional survey was performed in Hospital Universiti Sains Malaysia (HUSM), Malaysia. Medical record of 301 oral cancer patients was retrieved from the Medical Records office. Results: The majority of the oral cancer cases were male (62.8%), non-smokers (57.5%), non-alcohol consumers (83.4%), non-betel quid chewers (96.7%), and belonged to Malay ethnicity (68.8%). At the time of diagnosis, most of the patients were at stage II (38.9%). Approximately one-third (30.6%) of the total OC patients experienced loco-regional/distant metastasis, whereas no metastasis was detected in around two-thirds of cases (69.4%). A combination of surgery and radiotherapy was the most commonly employed treatment modality (27.2%). At the time of this study, the survival status of most of the patients was alive (69.1%). The most frequently encountered oral cancer in the Kelantanese population was oral squamous cell carcinoma (70.1%), with the tongue being the most frequently involved oral cavity site (35.5%). Conclusion: More than three-fourths of the cases were alive at follow-up, which included the cases that did not undergo any form of treatment.

Patient Satisfaction Towards Dentist-Patient Interaction Among Patients Attending Outpatient Dental Clinic Hospital Universiti Sains Malaysia

ABSTRACT Objective: To determine the satisfaction with the dentist-patient interaction and factors associated with patient satisfaction among patients attending the outpatient dental clinic Hospital Universiti Sains Malaysia (HUSM). Material and Methods: This cross-sectional study involved 229 patients who attended outpatient dental clinic Hospital USM that located in the East Coast region of Malaysia. A self-administered Skala Kepuasan Interaksi Perubatan - 11 (SKIP-11) questionnaire was used to assess the satisfaction towards dentist-patient interaction. Systematic random sampling was applied in this study. The data were analyzed using simple logistic regression analysis to determine the factors associated with patient satisfaction with dentist-patient interaction. Results: The mean age of patients was 32.6 ± 13.9 years, 71.6% of them study up to tertiary level, 31.5% came to for dental check up and 23.6% of them had tooth decay. More than half (64.6%) of the patients were satisfactory with dentist-patient interaction. The satisfaction percentage in the distress relief domain was 60.7%, 56.8% in the rapport domain, and 53.7% in the interaction outcome domain. Satisfaction with dentist-patient interaction was significantly associated with the dentists' characteristics such as age (OR = 0.583, 95%CI 0.44-0.76, p=0.001), gender (OR = 0.386, 95% CI 0.22-0.69, p=0.001) and years of service (OR = 0.294, 95% CI 0.15-0.57, p=0.001). Conclusion: The result showed that slightly more than half of the patients who attended the outpatient dental clinic HUSM were satisfied with the dentist-patient interaction, which was found to be influenced by the characteristics of the dentists. Efforts to improve patient-dentist interaction are recommended to ensure delivery of good quality oral health care.

New benefits of hydroxychloroquine in pregnant women with systemic lupus erythematosus: a retrospective study in a tertiary centre

Abstract Objective: To determine pregnancy outcomes in women with systemic lupus erythematosus (SLE) who were treated with hydroxychloroquine in a tertiary center. Methods: A retrospective study involving pregnant women with SLE who had antenatal follow-up and delivery in between 1 January 2007 and 1 January 2017. All participants were retrospectively enrolled and categorized into two groups based on hydroxychloroquine treatment during pregnancy. Results: There were 82 pregnancies included with 47 (57.3%) in the hydroxychloroquine group and 35 (42.7%) in the non-hydroxychloroquine group. Amongst hydroxychloroquine users, there were significantly more pregnancies with musculoskeletal involvement (p = 0.03), heavier mean neonatal birthweight (p = 0.02), and prolonged duration of pregnancy (p = 0.001). In non-hydroxychloroquine patients, there were significantly more recurrent miscarriages (p = 0.003), incidence of hypertension (p = 0.01) and gestational diabetes mellitus (p = 0.01) and concurrent medical illness (p = 0.005). Hydroxychloroquine use during pregnancy was protective against hypertension (p = 0.001), and the gestational age at delivery had significant effect on the neonatal birthweight (p = 0.001). However, duration of the disease had a significant negative effect on the neonatal birthweight (p = 0.016). Conclusion: Hydroxychloroquine enhanced better neonatal outcomes and reduced adverse pregnancy outcomes and antenatal complications such as hypertension and diabetes.

Anxiety in Malaysian children and adolescents: validation of the Screen for Child Anxiety Related Emotional Disorders (SCARED)

Abstract Objective Use of the Screen for Child Anxiety Related Emotional Disorders (SCARED) has increased significantly since its publication. Although the validity of the SCARED is well established, most of the samples investigated primarily comprised Caucasian children and, where available, people from Asian cultures such as China. Furthermore, the instrument's utility for screening use in community samples has yet to be validated, although it is commonly advocated for this use. The present study addressed the psychometric properties of the SCARED in a community sample of Malaysian children and adolescents. Method A total of 386 participants from an urban area, aged between 8 and 17, completed the 41-item SCARED. Confirmatory factor analysis and exploratory factor analysis were performed to investigate the factor structure of the SCARED. Results Internal consistency ratings for the SCARED's total and subscale scores were good, except for School Avoidance. The validity of the SCARED was further demonstrated through a significant correlation with the Internalizing subscale of the Strength and Difficulties Questionnaire (SDQ). In contrast with the five-factor structure proposed for primarily Caucasian samples, factor analysis revealed a four-factor structure for this Malaysian sample. Conclusions These research findings support the validity of the SCARED and its utility as a screening tool in a community sample of Malaysian children and adolescents.

Bacterial Colonization and Dental Implants: A Microbiological Study

Abstract Objective: To compare colony forming unit (CFU) of oral bacterial from buccal mucosa and lingual buccal tongue among patients with a dental implant and normal oral hygiene individuals without a dental implant. Material and Methods: Twenty-six individuals with a dental implant and twenty-six individuals without dental implants were included in this study. The samples were sent to the laboratory to culture with Brain Heart Infusion Broth (BHI), prepared serial dilution and then spread to the blood agar. CFU was counted when a single layer of bacteria is formed on the blood agar at any dilution level. An independent-T test was used to compare the means different of CFU oral bacterial between control and test groups from buccal mucosa and lingual buccal mucosa, respectively. Results: Buccal mucosa control group (186.19 ± 5.61) and test group (186.65 ± 6.24) (p>0.05). The result from the lingual buccal tongue control group (198.38 ± 6.12) and test group (197.96 ± 6.50) (p>0.05). There was no significant difference between the control group and test group CFU bacterial load. Conclusion: The presence of implants in the oral cavity do not interfere or worsen the oral condition; nevertheless, the effect of implants surrounding oral flora is similar to natural teeth.

Modeling the Growth of Bacteria Streptococcus sobrinus Using Exponential Regression

Abstract Objective: To build an exponential regression model based on parameter estimation. Material and Methods: We developed a simple mathematical model to simulate the growth of bacteria and the exponential growth is often used to model population growth as such cell growth while the exponential decay is portraying a declining or decreases in the size of the population. An exponential regression method was used to fit the data and estimate growth parameter values Streptococcus sobrinus using statistical software SPSS version 20. Results: Based on the results of the parameter estimates, which is constant are 83.039 and b1 is 0.005 while R-square is 0.952. According to the R-Square results obtained, the model is good and appropriate. Conclusion: The model can be used to find the potential biological parameters, which may be able to predict the treatment outcome. This study helps researchers to understand the specific growth rate(s), which can be used to best grow the organism.

Ricketts Cephalometric Analysis for Saudi Population

Abstract Objective: To evaluate the cephalometric norm for Saudi sample by Ricketts analysis (RA). Material and Methods: In this cross-sectional study, cephalometric radiographs were taken for 500 samples. The subjects included 250 males and 250 females. The ages of the subjects ranged from 18-30years. The criteria of selection were based on Class I incisor relationship, no skeletal abnormality and no previous orthodontic treatment. Lateral cephalometric radiographs were taken, traced and digitized by SPSS software, according to RA. An independent t-test was used to test the level of significance between genders. Results: Significant disparities found between Saudi males and females in dental and soft tissue measurements. The result showed that the distal position of the maxillary first molar to pterygoid vertical plane (U6 to Ptv) measurement was highly significantly greater (p<0.001) in Saudi males than females. Lower incisor to A-Pog (L1 to A-Pog) and lower lip to E plane was significantly longer (p<0.05) in Saudi males than females. Other measurements had no significant difference between Saudi males and females. Conclusion: The craniofacial morphology of the Saudi males was different from Saudi females using Ricketts analysis. This study will help the clinicians to diagnosis and treatment planning of orthodontic and orthognathic patients.

Soft Tissue Cephalometric Measurements Among Malaysian Malays and Chinese

Abstract Objective: To obtain the standardized values of individuals of Malaysian Malay and Chinese for further relevant research, such as treatment planning and aesthetical considerations. Material and Methods: In this retrospective study, 440 (305 were Malays and 135 were Chinese) standardized lateral cephalometric radiographs of orthodontic patients selected through simple random sampling are profiled using Holdaway's analysis. The independent t-test was used to assess the disparities in race and gender. The significant level was p<0.05. Results: Significant differences were found between the Malays and Chinese in their skeletal profile convexity, superior sulcus depth, inferior sulcus to the H line and nose prominence. Between Malay females and males, there are significant differences in superior sulcus depth, soft tissue subnasale to H line, basic upper lip thickness, upper lip thickness and nose prominence. Between Chinese males and females, there were differences in their skeletal profile convexity, upper lip to H line, basic upper lip thickness and upper lip thickness. Conclusion: The findings demonstrated the difference between standardized norms and the unique profiles of Malaysian Malays and Chinese. There are significant gender disparities in the soft tissue cephalometric measurements among Malaysian Malay and Chinese subjects.

The COVID-19 Pandemic - A Global Public Health Crisis: A Brief Overview Regarding Pharmacological Interventions

Abstract WHO reported that viral diseases remain as an international public health concern. Quite a lot of viral outbreaks such as the SARS coronavirus from 2002 to 2003, H1N1 influenza in 2009, and the MERS syndrome coronavirus in 2012, in the last two decades. The recent outburst of COVID-19 disease has to turn out a global public health catastrophe that has a profound consequence on every aspect of human life. Currently, national governments, international health agencies, UN different bodies are working relentlessly to find the best way to save and mitigate our world from the shattering effects of COVID-19. Simultaneously, all related scientists around the planet determinedly made enormous efforts to find the COVID-19 transmission process, clinicopathological issues, diagnostics tools, and prevention policy planning and pharmacological intervention approaches. There are many problems that are not resolved regarding COVID-19, like the virus-host relations and the development and progression of the pandemic, with precise reference to the times when the current pandemic will reach its ultimate level to produce maximum damage. At this moment in time, yet we do not possess and definite and specific treatment options to fight with the COVID-19 viral infectious diseases. Currently, the majority of the scientist is involved in finding a way through drug repurposing. Up to the present time lot of medicines were identified that possess definite antiviral effects against COVID-19 but need to go a long way with well-designed study to obtain the best possible answer. After that, to this point, supportive and preventive remain as the best weapon.

Factors Influencing Oral Health-Related Quality of Life Among Preschool Children in District of Kota Bharu, Malaysia: A Cross-Sectional Study

Abstract Objective: To assess caries experience and its association with oral health-related quality of life (OHRQoL) of preschool children in Kota Bharu, Kelantan, Malaysia. Material and Methods: A sample of 169 preschool children of 5-6-year-old at a private preschool in the district of Kota Bharu, Kelantan was participated and were subjected to an oral examination to determine their caries experience by a single calibrated dentist. The parents were responding to self-administered Malay-ECOHIS and their socio-demographic background. Descriptive, Chi-square test and Spearman correlation were done to analyse the data required in this study. Results: Subjects comprised of girls (55.6%) with most parents (39%) had a secondary level of education, and 47.9% of them had a monthly income of RM1000-RM2999. Caries prevalence was 74.6% with a mean (SD) dmft was 5.27(5.22). The impacts on OHRQoL were more prevalent in the family section of Malay-ECOHIS (12.5%; 95%CI: 7.5%-17.5%) than the child section (4.2%; 95%CI: 1.16%-7.24%). Items related to 'felt guilty' (22.5%; 95%CI: 16%-29%) and 'been upset' (20.2%; 95%CI: 14.1%-26.3%) were the frequently reported on the family impact section. In child impact section, the item related to 'pain' (36.7%; 95%CI: 30%-43%) and 'difficulty eating' (20.8%; 95%CI: 14.7%-26.9%) were reported more frequently. Children with caries experience were significantly associated with the impact on family OHRQoL (p<0.05). Conclusion: The presence of dental caries was a significant predictor of poor OHRQoL.

Accuracy of Cone Beam Computed Tomography in the Assessment of Mandibular Molar Furcation Defects

Abstract Objective: To evaluate the accuracy of cone-beam computed tomography (CBCT) in the assessment of mandibular molar furcation defects. Material and Methods: Thirty patients with furcation defects were selected, oral hygiene instructions, scaling, and root planing with ultrasonic devices and hand instruments and occlusal adjustments were performed. Pre-surgical clinical measurements were carried out at the buccal aspect of the selected mandibular molars. The horizontal furcation measurements were measured with a Nabers Probe starting at the furcation entrance to the greatest horizontal depth. The degree of furcation involvement was graded from 0 to III. Bone loss in the horizontal and vertical direction and the width of the furcation entrance were measured on CBCT and after reflecting the full-thickness flap and debridement of the defects. The data were analyzed using t-test and Pearson's correlation coefficient. Results: The width of furcation entrance in clinical method was 3.27 ± 0.77, while in CBCT method was 3.35 ± 0.71, clinically the vertical bone loss was 3.61±1.09, while in CBCT was 3.57 ± 1.15, horizontal bone loss in clinical method was 5.08 ± 2.21, while in CBCT was 5.11 ± 2.23. No significant difference between the two methods was noted, and a high correlation between the two methods was observed. With regards to the agreement between the two methods of assessment, the width of furcation entrance revealed a difference between the two methods by 0.08 ± 0.21, while vertical bone loss showed difference between the two methods by -0.04 ± 0.19, the horizontal bone loss showed a mean difference between the two methods by 0.03 ± 0.21. Conclusion: CBCT provided high accuracy for the furcation involvement detection and anatomy of surrounding periodontal tissues.